Retooling reimagined
Let’s ponder another challenge: the need to add to your repertoire a new, potentially transformative skill. How do we safely retool?
Twenty years ago, in the flawed early adoption of laparoscopic surgery, the ACS Committee on Emerging Surgical Technology Education articulated the principles of new skill acquisition: didactic learning, coupled with simulation-based training, and then proctored early experience, leading to independent practice and assessment of outcomes.
Subsequently, the College took the visionary step of establishing the ACS Accredited Education Institutes (AEI) program to develop a network of centers that would leverage emerging simulation technologies to enhance surgical training. The 96 national and international AEIs now serve as both educational and research centers to teach technical and nontechnical skills to surgeons and other health care professionals. At Houston Methodist Hospital, for example, we have built MITIE (Methodist Institute for Technology Innovation and Education), a comprehensive center with a focus on retooling surgeons in practice. We have hosted more than 13,000 surgeons in practice for retooling hands-on courses, along with more than 30,000 other health care professionals.
To ensure our surgical workforce stays at the top of their performance over a 40-year career, our College has convened a group of stakeholders, including payers, consumers, liability carriers, surgical technology industries, hospital executives, and, of course, surgeons, to define the infrastructure – facilities, faculty, curricula, assessment tools, and finances – needed to incorporate retooling and retraining into our health care system. Work to do.
Shape your future
The retooling reimagined initiative is but one example of how we can shape our professional futures. Remember, the ACS was founded nearly 105 years ago by surgeons who sought to improve the care of the surgical patient. Since then, individual surgeons, banding together within our College, have created some of the most effective systems in the world to improve surgical care – including the formation of the Committee on Trauma and the Commission on Cancer, which have led initiatives that have vastly improved care for their respective patient populations.
The ACS National Surgical Quality Improvement Program, born of the vision of Shukri Khuri, MD, FACS, who, when tasked with resolving a perceived problem in surgical care in the Veterans Affairs Health Care System, launched a research study to measure quality. Soon thereafter, he led an army of surgeons to improve surgical care in their own hospitals, founding a nationwide movement that now flourishes in thousands of hospitals as the world’s most effective surgical quality measurement and improvement system.
We can go on and on. A surgeon identifies a gap and with a good idea, and coupled to abundant College focus and the engagement of our Fellows, a valuable new program is launched. These initiatives were not delivered from on high. They were created by regular surgeons, like you and me, who saw gaps in their professional worlds and took steps to effect meaningful change.
Caring for each other
I have one more request: I want you to be aware of your colleagues. I want you to watch them for signs of stress and disturbances in their forces. And if you see something, ask a supportive question or offer needed assistance. Be aware of help that is available in your institution; know how to move a concern up the chain with sensitivity, but also with efficacy, coupled with compassionate concern for your colleague.
These are not easy discussions and may prove fruitless, but they are worth the effort to try, for we surgeons are a high-risk group for depression, substance abuse, and suicide – and for failing to seek assistance. This situation must change, but doing so will require that we destigmatize these conditions in ourselves and our colleagues, and destigmatize seeking assistance.
But, for now, on a joyful or a challenging day in your surgical life, I hope you are proud of your Fellowship in the ACS and your FACS initials that signify your commitment to the values of our profession. I hope you will draw endless support and friendship from those around you and that you will contribute more than you receive. And I hope that you will forever treasure your opportunity to practice as a surgeon, an exceptional joy and privilege.
Dr. Bass is the John F. and Carolyn Bookout Presidential Endowed Chair, professor of surgery and chair, department of surgery, Houston Methodist Hospital, TX, and the President of the American College of Surgeons (ACS).