Do surgeons have a role as infectious disease consultants?
S. M. Cohn and B. T. Fisher
Department of Surgery, Yale School of Medicine, New Haven, Conn., USA.
BACKGROUND: Antibiotic drug restriction policies have become widespread in
North America hospitals mandating medical infectious disease consultation
for use of routine antimicrobial agents. OBJECTIVE: To determine physician
and institutional attitudes regarding the credibility of surgeons in the
area of infectious disease. DESIGN: A survey of the Surgical Infectious
Disease Society (SIS) membership. PARTICIPANTS: Members of the SIS
practicing in the United States and Canada (n = 464) were sent a simple
opinion poll regarding surgical infectious disease specialists. After
receiving the survey, the SIS members were given approximately 4 weeks to
anonymously complete the questionnaire and return it to our office.
RESULTS: Responses were received from 198 SIS members (43%). Most were from
large (> 400 bed) institutions (63%), and the majority of them were from
university centers (76%). Predictably, 86% of the respondents were in
full-time academic practice. Some SIS respondents (21%) had undergone
special training in infectious disease, and of these, 63% actually had
completed a formal surgical infectious disease fellowship. Antibiotic
restriction policies were nearly universal and required in 87% of
institutions. Only 44% of surgeons in these hospitals, however, were
privileged to release antibiotic drugs. Medical infectious disease
physicians recognized surgical expertise in infectious disease in few
instances (32%). The great majority of responding SIS members (81%)
believed that an examination or certification in infectious disease for
surgeons was not warranted. CONCLUSIONS: Antibiotic drug restriction is
prevalent in North America, and medical infectious disease specialists do
not generally recognize surgical expertise in the area of infectious
disease. Despite this environment, responding SIS members believe that
special credentialing of surgeons in the area of infectious disease is
unnecessary.
