Joel S. Weissman, PhD Deputy Director/Chief Scientific Officer Center for Surgery and Public Health Brigham and Women's Hospital/Harvard Medical School Professor of Surgery (Health Policy) Harvard Medical School

Most Military Surgeons Unprepared for Combat Care

MedicalResearch.com Interview with:

Joel S. Weissman, PhD Deputy Director/Chief Scientific Officer Center for Surgery and Public Health Brigham and Women's Hospital/Harvard Medical School Professor of Surgery (Health Policy) Harvard Medical School

Dr. Weissman

Joel S. Weissman, PhD
Deputy Director/Chief Scientific Officer
Center for Surgery and Public Health
Brigham and Women’s Hospital/Harvard Medical School
Professor of Surgery (Health Policy)
Harvard Medical School

MedicalResearch.com: What is the background for this study?

Response: Over time, the military health system has been shifting care for its soldiers and their families away from big military treatment facilities (MTFs), allowing soldiers and their families to get care from civilian hospitals.  But this has had an unintended consequence.  Unfortunately, it means that military surgeons are getting fewer cases, and they are worried about maintaining their skills as surgeons.  But some surgeries count more than others to help prepare the surgeon for battlefield casualties. 

MedicalResearch.com: What are the main findings?

Response: Our study took advantage of a newly developed technique — the Knowledge, Skills and Abilities (KSA) tool — to use peacetime caseloads to estimate surgeons’ readiness for combat deployment.  The team analyzed the workload of general surgery performed across the U.S. Military Health System and calculated KSA values to compare metrics from 2015 to 2019. We found that the proportion of general surgeons who met the minimum readiness threshold decreased 40% during that time period; and by 2019, only 10% of general surgeons had enough experience under their belts to be considered ready for combat clinical care.

MedicalResearch.com: What should readers take away from your report?

Response: This gradual shift in the volume of surgical cases from MTFs to civilian hospitals has led to a precipitous decline in the clinical preparedness of military surgeons for combat medical care.  

MedicalResearch.com: What recommendations do you have for future research as a result of this work?

Response: Future research should include the experience of military surgeons who perform off-duty surgeries, or who serve in the reserves.  Furthermore, the military should experiment with different models of care that provide military surgeons with the volume of cases they need to maintain their skills.

No disclosures.

Citation:

Dalton MK, Remick KN, Mathias M, et al. Analysis of Surgical Volume in Military Medical Treatment Facilities and Clinical Combat Readiness of US Military Surgeons. JAMA Surg. Published online October 27, 2021. doi:10.1001/jamasurg.2021.5331

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Oct 27, 2021 @ 3:42 pm

 

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