In Training - Vol. 1, Issue 1

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Simulation Training Mimics OR S

imulation training is now a mandatory aspect of every surgeon’s medical education in the United States. The rise of simulation training roughly parallels that of laparoscopic surgery; in the early- and mid-1990s as laparoscopy swept through the country, surgeons at academic centers noted a distinct, severe learning curve for laparoscopic techniques. In particular, training for one of the most basic laparoscopic procedures, the laparoscopic cholecystectomy, varied widely and injuries to the bile duct became increasingly common.1 In some cases, experienced surgeons with excellent operative techniques in

open cases could not perform the most basic laparoscopic techniques. “We wanted to teach people how to tie a knot laparoscopically and guys who were very good at open surgery just couldn’t tie a knot,” said Daniel Jones, MD, professor of surgery at Harvard Medical School and chief of minimally invasive surgery at Beth Israel Deaconess Medical C e n te r, b o t h i n Boston. “And as you can imagine, that’s a problem in surgery.” Simulation pro– vided a way to train surgeons without compromising the future of laparoscopy by cataloging reports of technique-related see TRAINING, page 4

Health Care Reform for Surgeons

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n March 2010, after months of intense wrangling in Congress, a significant health care reform bill became law in the United States. Despite the size of the bill, roughly 2,000 pages detailing everything from government insurance coverage of abortion to “end-of-life services,” experts in health policy say it is still unclear how the Patient Protection and Affordable Care Act will affect surgeons. “When you ask the question, ‘What’s the impact on surgery?’ it’s really a very complex, multiyear, multifaceted process,” said Charles Mabry, MD, a private

practice general surgeon in Pine Bluff, AK, who is chairman of the American College of Surgeons Health Policy Steering Committee. One aspect, Dr. Mabry says, is that the bill rolls out in phases. Parts of the bill take effect this fall; others will take effect years from now. Furthermore, regardless of what may be written on paper, the implementation of the health care reform law will be in the hands of the regulatory agencies that enforce legislation. Finally, at least 20 states have filed see HEALTH CARE REFORM, page 9

INSIDE: IN PRACTICE Follow these tips for financial success in your surgical practice.

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IN TECHNOLOGY A discussion of energy delivery devices in surgery.

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IN THE OR The role of ghrelin and other gut hormones in metabolic surgery.

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IN THE FUTURE Deciding on a surgical career in academia vs private practice.

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In Training - Vol. 1, Issue 1 by McMahon Group - Issuu