Nancy Humber1, Temma Frecker. 1. Department of Family Practice (Research Division), University of British Columbia, Vancouver, BC. Saffron2@telus.net
Abstract
OBJECTIVE: To document surgical procedures performed in British Columbia between 1996 and 2001 at rural hospital sites with no resident specialist surgeons and to define the scope of practice of general practitioner (GP)-surgeons at these small-volume surgical sites. METHODS: We obtained data from published information available in the medical directories for British Columbia and from the Population Utilization Rates and Referrals For Easy Comparative Tables database (versions 6.0 and 9.0) to conduct a retrospective study of all rural BC hospitals with surgical programs that had no resident specialist surgeon and relied on GP-surgeons for emergency surgical care between 1996 and 2001. We studied surgical programs at the 12 hospitals that met inclusion criteria and interviewed the physician or nurse responsible for the program. Outcomes were measured in terms of the types and volumes of surgical procedures (elective and emergency) from 1996 to 2001, including itinerant surgery. RESULTS: On average, 2690 surgical procedures were performed annually at the 12 hospitals included in the study. Endoscopy, hand surgery, cesarean section, herniorrhaphy, tonsillectomy and dilation and curettage (D&C) were among the top elective and emergency procedures. For each hospital, between 8 and 26 procedures of hand surgery, cesarean section, herniorrhaphy, D&C and appendectomy were performed each year. In the 12 communities studied, 19% of all surgery was emergency and 81% elective. There was significant overlap in the types of emergency and elective procedures. GP-surgeons carried out most of the emergency procedures, which nonetheless accounted for a small portion of their surgical work. CONCLUSION: GP-surgeons still perform a significant number of emergency and elective surgical procedures in rural BC hospitals. This study defines useful procedures for GP-surgeons in communities without the population base to sustain a resident specialist surgeon. This information can be used to structure training programs for GP-surgeons that will adequately meet the needs of rural communities.
OBJECTIVE: To document surgical procedures performed in British Columbia between 1996 and 2001 at rural hospital sites with no resident specialist surgeons and to define the scope of practice of general practitioner (GP)-surgeons at these small-volume surgical sites. METHODS: We obtained data from published information available in the medical directories for British Columbia and from the Population Utilization Rates and Referrals For Easy Comparative Tables database (versions 6.0 and 9.0) to conduct a retrospective study of all rural BC hospitals with surgical programs that had no resident specialist surgeon and relied on GP-surgeons for emergency surgical care between 1996 and 2001. We studied surgical programs at the 12 hospitals that met inclusion criteria and interviewed the physician or nurse responsible for the program. Outcomes were measured in terms of the types and volumes of surgical procedures (elective and emergency) from 1996 to 2001, including itinerant surgery. RESULTS: On average, 2690 surgical procedures were performed annually at the 12 hospitals included in the study. Endoscopy, hand surgery, cesarean section, herniorrhaphy, tonsillectomy and dilation and curettage (D&C) were among the top elective and emergency procedures. For each hospital, between 8 and 26 procedures of hand surgery, cesarean section, herniorrhaphy, D&C and appendectomy were performed each year. In the 12 communities studied, 19% of all surgery was emergency and 81% elective. There was significant overlap in the types of emergency and elective procedures. GP-surgeons carried out most of the emergency procedures, which nonetheless accounted for a small portion of their surgical work. CONCLUSION: GP-surgeons still perform a significant number of emergency and elective surgical procedures in rural BC hospitals. This study defines useful procedures for GP-surgeons in communities without the population base to sustain a resident specialist surgeon. This information can be used to structure training programs for GP-surgeons that will adequately meet the needs of rural communities.
Authors: Nadine Caron; Stuart Iglesias; Randall Friesen; Vanessa Berjat; Nancy Humber; Ryan Falk; Mark Prins; Victoria Vogt Haines; Brian Geller; Fred Janke; Robert Woollard; Bret Batchelor; Jared Van Bussel Journal: Can J Surg Date: 2015-12 Impact factor: 2.089
Authors: Richard Fleet; Fatoumata Korika Tounkara; Mathieu Ouimet; Gilles Dupuis; Julien Poitras; Alain Tanguay; Jean Paul Fortin; Jean-Guy Trottier; Jean Ouellet; Gilles Lortie; Jeff Plant; Judy Morris; Jean Marc Chauny; François Lauzier; France Légaré Journal: BMJ Open Date: 2016-04-20 Impact factor: 2.692
Authors: Marquise Kouo-Ngamby; Fanny Nadia Dissak-Delon; Isabelle Feldhaus; Catherine Juillard; Kent A Stevens; Martin Ekeke-Monono Journal: BMC Health Serv Res Date: 2015-10-23 Impact factor: 2.655