Although there's a perception that rural general surgeons need to be prepared for every kind of surgery under the sun, the preliminary study findings actually show that "rural hospitals concentrate on relatively narrow set of low complexity inpatient procedures performed on relatively low?risk patients."
"In reality most of what's being done are, if you will, the bread-and-butter general-surgical types of procedures," says Doescher. "The take-home message from the study is that in rural locations compared to urban locations, general surgeons focus actually on the most common types of procedures."
According to Doescher, the findings suggest a need for training within general surgery residencies that equips general surgeons in rural areas to perform not only general surgery procedures, but also the basics of other specialties, too.
"Really we need an emphasis on training tracks that can produce rural general surgeons with this bread-and-butter type of skill set, with the addition of things that currently fall outside of general surgery training," Doescher says.
For example, after completing a program like this, Doescher says general surgeons should also be able to perform basic obstetrics procedures such as c-sections; orthopedics procedures such as pinning a hip after a hip fracture; and possess good endoscopic skills in the outpatient arena.
If that happened, he says "you'd actually be producing a very viable, rural, general surgery workforce."
Although much of this shift needs to happen at the medical-school and residency level, Doescher says it's an issue that should also be top-of-mind for rural hospital executives.