New directions in gastrointestinal surgery.

Current trends in national health care are triggering a reassessment of the relationship between gastrointestinal surgery and its parent discipline, general surgery. This paper proposes that general surgery be recognized as a broad-based specialty that provides efficient, cost-effective surgical care across a wide spectrum of diseases, whereas gastrointestinal surgery should be acknowledged as the field emerging from general surgery that deals with advanced surgical care in digestive diseases. The Society for Surgery of the Alimentary Tract, with the strength of its talented membership, should take the lead in developing this new role for gastrointestinal surgery. It should urge public recognition of surgical gastroenterology, broaden its membership in the field, define guidelines for practice, develop research and educational programs, and promote national and international cooperation in gastrointestinal surgery. The net result should be the strengthening of both gastrointestinal surgery and general surgery.