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The Private Practice View

Arthur L. Trask, MD; Daniel R. Faber

Arch Surg. 1990;125(9):1105-1108.

Abstract
• In the past 10 years, a number of authors have expressed concern that surgeons are abdicating their traditional role of providing preoperative and postoperative care in surgical intensive care units. To study today's private practice environment, we took a survey. Questionnaires were sent to the chiefs of surgery and the nurse managers of the surgical intensive care units at 188 non—university-affiliated hospitals throughout the United States. Results show that surgeons do not have the principal managing role in the intensive care unit for surgical patients in 70% to 75% of the hospitals. Results also indicated that surgeons are relinquishing their responsibilities in the direct care of the preoperative and postoperative critically ill patients. Three main reasons are given for this: (1) an ever-increasing body of critical care knowledge plus complex technology, (2) a lack of economic incentive, and (3) professional liability. To reverse this trend, these three areas must be addressed.

(Arch Surg. 1990;125:1105-1108)

Author Affiliations
From the Department of Surgery, University of Miami (Fla) School of Medicine (Dr Trask). Mr Faber is an independent medical researcher/writer. Dr Trask is now with Fairfax Hospital, Falls Church, Va.

Footnotes
Accepted for publication April 21, 1990.

Presented at the 1989 Clinical Congress of the American College of Surgeons, Atlanta, Ga, October 18, 1989.

Reprint requests to Director, Trauma Services, Fairfax Hospital, 3300 Gallows Rd, Falls Church, Va 22046 (Dr Trask).

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