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Building a Successful Academic Practice Using the Three A’s: Availability, Affability and Ability |
T. Clark Gamblin |
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Initiating a successful clinical practice has many elements, and most young surgeons are unaware of the existing structure for patient intake/communication in the clinical practices they join after training. Most academic centers have existing mechanisms for patient intake and outside physician referrals, which may be a central call center and/or practice-based methods of patient intake, such as staff within a division office. In the absence of existing mechanisms, resources such as these are sometimes established in the negotiating phase of recruitment and include aspects such as commitment of personnel, resources, and mentorship. In academic medicine, teamwork and a group practice mentality is essential, and successful groups are able to meld various talents to provide a unique culture with a central vision and mission. The core values of the practice, division, or department must align with newly recruited members to promote professional satisfaction and success for both the individual and the group.
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Outline for “Developing Relationships” Chapter (Wang/Beck) |
Matthew A. Nehs,Adil Haider |
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Professional relationships are the life-blood of surgical practice. They are what connect you to your patients through trust and honesty; they allow you to tap into the experience and wisdom of senior faculty; they lay the foundations for students, residents, and fellows on their path towards competence and mastery; and they connect you to referring physicians who commission you to solve a surgical problem. As a new surgical faculty member, establishing these important relationships is among your most important tasks. Here we share a few tips on how to involve and learn from senior faculty in your institution.
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Developing Relationships: Building Patient Relationships |
Heather Wachtel,Rachel R. Kelz |
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Building patient relationships is a key component of clinical practice. Good provider-patient relationships can improve patient outcomes, enhance compliance, and decrease the potential for medico-legal action after adverse events. Surgeon-patient relationships inherently require a high degree of trust. Strong communication and setting clear expectations can help optimize surgical care, and assist in building a clinical practice.
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Building Multidisciplinary Teams in the Digital Age |
Thomas K. Varghese Jr |
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Richard Buckminster Fuller was an American architect, designer and inventor who amongst his many accomplishments in 1982 came up with the concept of the “knowledge-doubling curve” [1]. He noted that until the year 1900, human knowledge doubled approximately every century. By the end of World War II, knowledge was doubling every 25 years. Today, the rate of knowledge doubling is every 12 months, with predictions of 12 h in 2020 with the launch of the ‘Internet of Things’. It is impossible for a single human being to be a content expert in every facet of their field without help.
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First Year “Must Do’s”: Prepared for Building a Clinical Practice |
Andrea Obi,Shawn Obi |
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The leap from graduating chief resident or fellow to attending physician is one of the most critical and daunting times in a surgeon’s career. Here, we have outlined key “must dos” in the first year to ensure that milestones are reached and the research mission and personal/family life does not suffer during the course of building an academic clinical practice. This includes identifying requirements for board certification early and planning backwards from these dates; developing a strategic debt management plan, retirement and insurance plan; keeping a case log and identifying clinical mentors. The basics of laboratory set up including how to leverage mentors’ experience when hiring laboratory staff, negotiating research regulations, and curating a reputation are emphasized.
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The Resilient Academic Surgeon |
David A. Rogers,Brenessa Lindeman |
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Resilience is defined as the ability to withstand adversity or other challenges. A resilient academic surgeon can navigate through various challenges to stay engaged in patient care, scholarship and teaching. This capacity is currently under considerable threat given the escalating demands that are due to a variety of forces including technical innovations, increasing societal expectations and decreasing funding that are all occurring in the midst of a disruptive reformation of healthcare. The culture of surgery suggests that improvement can occur if we are willing to embrace the idea that there is a need to improve our resilience. There are approaches shown to do this in individuals and the conceptual frameworks that are the basis of these interventions are also what has been shown to be helpful when surgeons face adversity. In order for real change to occur, we must begin the process of teaching resilience to our learners and creating the next generation of academic surgery leaders who are more enlightened about how to create work that is most engaging for academic surgeons.
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Running a Basic Science Lab |
Salvatore T. Scali,Scott A. Berceli |
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Surgeon-scientists who supervise basic science laboratories are an essential component of the field of academic surgery and contribute to the fundamental understanding and treatment of disease through discovery and application of innovative therapies. A surgeon-scientist is defined as a surgeon who is engaged in bench research, usually translational in nature, and across a variety of fields including genetics and genomics, cell and development molecular biology, proteomics, lipidomics, biomedical engineering, systems biology, and more recently, machine learning and computational-patient interfaces [1]. Due to the increasing complexity of the fields in which surgeon-scientists are engaged, there has been an evolution over the past three decades from being an isolated bench researcher to his/her incorporation into groups of investigators working together in multidisciplinary teams (e.g. ‘team science’). This change has been fostered by the unique attributes of surgeon-scientists who are positioned to be the key conduit for translational application of novel therapies into clinical practice.
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Creating Balance Between Your HSR Academic Development and Clinical Practice |
Jayme E. Locke,Luke M. Funk |
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Creating balance between your health services research (HSR) academic development and clinical practice begins long before your first day on the job. Ensuring your academic and clinical success requires thoughtful attention to detail as you explore job opportunities and critically evaluate and appraise various job offers. Garnering sage advice from mentors as you begin your journey toward becoming a surgeon-scientist is invaluable. One certainly would not enter the operating theatre having not examined the patient, reviewed pertinent laboratory and radiographic data, or spoken to a senior colleague, and one should approach finding their first faculty job with no less vigor. There are three broad phases one must navigate along the way.
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The Incorporation of Surgical Education into Clinical Practice |
Dawn M. Coleman |
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A central and hugely gratifying pillar of academic surgery is the education of learners across multiple tiers of training. Surgical training is in continuous evolution. Traditional surgical education placed emphasis on (1) obtaining information about diseases and (2) the development of technical abilities by primarily observation and by then operating on patients. The changing landscape of surgery that increasingly emphasizes quality and patient-centered care with shared decision making coupled with growing technology, educational aids (e.g., simulation) and the incorporation of ‘adult learning’ methods have defined modern surgical training as the ‘production of competent surgeons that display cognitive, technical and personal skills required to meet the needs of society’ [1]. It is no surprise that the meaningful incorporation of surgical students, residents, and fellows into clinical practice requires a sincere commitment, time, advanced planning, and system level support. This chapter proposes lessons for their efficient, safe, effective training, and mentorship while also offering current opportunities for professional educational development.
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Incorporating Clinical Trials in Your Practice |
Douglas W. Jones,Mary Trovato,Marc L. Schermerhorn |
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Academic surgeons should recognize the importance of clinical trials and consider participation as an essential component of advancing surgical knowledge. For investigators who wish to initiate or take leadership roles in trial research, experience in clinical research and clinical expertise are essential. Early investigators should seek to define a focus area and take advantage of early career research opportunities. Industry-sponsored and non-industry-sponsored trial opportunities should be pursued where they overlap with clinical interests and expertise. The commitment can vary from site-level co-investigator to national principal investigator. Familiarity with the mechanics of clinical trial conduct is essential for enrolling suitable patients and assuring compliance. Both Investigators and study enrollees benefit from participation in clinical trials as long as they are conducted ethically.
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When to Say No (or Not to Say No): Balancing Academic Development with a Clinical Practice |
Lesly A. Dossett,Christopher J. Sonnenday,Justin B. Dimick |
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One of the greatest challenges for an academic surgeon is time management. During the training continuum in medical school, residency and research or clinical fellowships, time demands are rather structured. During clinical training, the focus is singularly on learning the clinical discipline with little time for academic development or pursuits. Conversely, during academic development or research time, clinical duties are minimal, leaving dedicated time to focus on research. Typically for the first time, the young academic surgery faculty member has considerable autonomy over his or her time and therefore must learn to balance time commitments between the various missions.
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Joining and Becoming Involved in Surgical Societies |
Jess Fazendin,Lillian Kao,Herb Chen |
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Surgical societies can provide many benefits to both the careers and personal lives of their members. Professionally, they serve to unite members through research and education. The American College of Surgeons (ACS), established in 1913 by Dr. Franklin Martin, is one of the largest professional societies in North America. Its aim is to “promote the highest standards of surgical care through education of, and advocacy for, its Fellows and their patients, and to safeguard standards of care in an optimal and ethical practice environment” [1]. While the ACS acts as a professional society for surgeons in various communities, others exist to connect surgeons in academia. For example, the Association for Academic Surgery (AAS) aims to inspire and develop young academic surgeons, and the Society of University Surgeons (SUS) seeks to support and advance leaders in academic surgery.
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Building Relationships with Hospital Administrators |
Sarah E. Tevis,Gregory D. Kennedy |
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In order to understand the importance of the relationship between hospital administrators and physicians, it is imperative to appreciate how Health Care Organizations (HCOs) have changed over the last 100 years (Fig. 13.1). In the late 1800s, public and private hospitals were distinguished and private health insurance was developed by the early 1900s [1]. At that time, hospital were owned and managed by physicians [2]. Following World War II, technology in health care rapidly advanced leading to increases in hospital costs [1]. Also around that time, physicians began to focus more on clinical work and administrators began taking over daily administrative tasks [2]. Hospitals consisted of a small group of managing administrators, physicians, and nurses. Patients paid medical bills in cash and cost of care was the cost of services plus a small predetermined profit margin [3]. The financial success of hospitals in the 1950s was dependent on having hospital beds filled.
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New Technologies-Adopting and Leading Your Hospital in Innovation |
John R. Porterfield Jr |
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A young surgeon’s success vitally depends on building a robust clinical practice. In this chapter, we will focus on the adoption of new technologies for surgeons and how surgeons can best lead their hospitals to invest in innovation wisely. While there is no magic formula and little data to guide surgeons in the subtle art of communication with hospital leadership, this chapter will focus on foundational principles that produce positive outcomes. This approach focuses on quality care delivered to the patient by the health system, including trainees, and appropriate partnership with industry.
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Quality Improvement and Quality Metrics |
Carrie Y. Peterson |
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The quality movement in medicine is not a new idea, but it has become increasingly complex and nuanced. This chapter will review the basics of quality assessment and improvement in medicine, briefly discuss the various important programs, organizations and persons, explore data sources and metrics that inform quality decisions, and discuss how culture can influence outcomes and quality improvement. This chapter will focus on providing the basic information a young surgeon new to practice would find useful for understanding quality improvement and its impact on everyday health care.
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