SURGERY FOR RURAL AMERICA Thomas H. Cogbill, M.D. Gundersen Lutheran Medical Foundation La Crosse, Wisconsin.

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Presentation transcript:

SURGERY FOR RURAL AMERICA Thomas H. Cogbill, M.D. Gundersen Lutheran Medical Foundation La Crosse, Wisconsin

Gundersen Lutheran Health System Fully Integrated Physician-Led 453 Physicians 6159 Employees

Main Clinic – La Crosse, Wisconsin (population 51,000) 12 General Surgeons Branch Clinics – 25 Locations 9 General surgeons

GL SURGICAL RESIDENCY Began in 1974 Currently 2 Categorical Positions/Year Only Surgical Residency Single Fellowship – Bariatric/MIS

GL SURGICAL RESIDENCY Committed to General Surgery High Volume Open Cases High Volume Laparoscopic Cases Critical Care – 2 Months (R1/R3) R4/R5 Trauma Resuscitation Leaders

GL SURGICAL RESIDENCY Obstetrics/Gynecology – 2 Months (R3) High Volume Endoscopy – 2 Months (R3/R4) Rural Surgery Elective – (R4) Practice-Based Learning Curriculum

Practice Management Curriculum Ethics Grand Rounds (6/year) Coding & Reimbursement MalpracticeContracts Practice Management

Rural Surgery Elective Prairie du Chien, Wisconsin (pop 6047) Decorah, Iowa (pop 7944) Anticipated Practice Sites

Emphasis on Academics Require 2 Publications Require 2 Presentations Evidence-Based Learning

Graduates Fellowship24% Urban/Large Rural General Surgery26% Small Rural General Surgery50%

Postgraduate Responsibility 1. Faculty clinical resource 2. CME programs 3. Teaching ATLS a. ATLS Rural elective b. Rural elective

Essentials for Rural Surgery Strong 5-Year Core General Surgery Obstetrics/GynecologyEndoscopy Surgical Subspecialties Practice Management Curriculum Full Immersion Rural Surgery Elective