Future of Surgery

[theduke]

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I'm an undergrad w/ a definite interest in surgery.

I would like to know what will happen to surgery and its specialties as technology becomes more advanced and minimally invasive and non-invasive technology is being developed.
Does this mean the role of the surgeon is contracting?

Thanks!

 

[powermd]

Certain specific surgeries will probably decrease significantly due to minimal/non-invasive technique, as has happened with CABG surgeries. This will probably decrease the need for cardiac surgeons in the future. There will still be CABG surgeries, but they will be limited to the patients who failed medical and intravascular therapies. The surgical subspecialties- ophtho, ortho, ent, plastics, and neuro should still have plenty of work over the next 50 years. General surgeons will still have appys, choles, bowel surgery, trauma, bariatrics, breast surgery, and minor procedures that won't go away (port-o-caths, lipomas, butt abscesses, ulcer debridements, etc). The aging baby-boomers will increase the demand for all surgery considerably.

If you are interested in surgery, there will still be plenty of jobs available by the time you get there. Of course, it's always a bit harder to land a job in a major city.

 

[theduke]

what about robotic surgery? how will that effect the role of the surgeon in the operating room?

 

[Mirror Form]

Originally posted by powermd
Certain specific surgeries will probably decrease significantly due to minimal/non-invasive technique, as has happened with CABG surgeries. This will probably decrease the need for cardiac surgeons in the future. There will still be CABG surgeries, but they will be limited to the patients who failed medical and intravascular therapies. The surgical subspecialties- ophtho, ortho, ent, plastics, and neuro should still have plenty of work over the next 50 years. General surgeons will still have appys, choles, bowel surgery, trauma, bariatrics, breast surgery, and minor procedures that won't go away (port-o-caths, lipomas, butt abscesses, ulcer debridements, etc). The aging baby-boomers will increase the demand for all surgery considerably.

If you are interested in surgery, there will still be plenty of jobs available by the time you get there. Of course, it's always a bit harder to land a job in a major city.

I've actually seen some articles predicting that CT surgeons will be the most needed speciality once the baby boomers hit. They still have plenty of work right now too, provided that they're willing to suck up to the cardiologists.

 

[droliver]

Originally posted by theduke
what about robotic surgery? how will that effect the role of the surgeon in the operating room?

This is a topic a few people write about with enthusiasm but seems so peripheral as to not be very important.

-The costs for the capital equipment purchase & maintainance are prohibitive. Hospitals that have them use them only as loss-leaders for publicity purposes.

-Many of the procedures described, especially laparoscopically, can already be done faster & cheaper by people with advanced laparoscopy skills. The only thing that seems like an interesting area to me is the utility with minimally invasive off-pump cardiac surgeries. There would seem to be a role there.

-The potential for off-site surgery is always going to be undercut by the fact that you'll need someone present who can do the operation or handle complications.


In an era where the funding for our health care system is falling apart, I just don't see how this expensive technology with some questionable indications is going to take hold in the near future. There really is no great "need" crying out for development of this & that's going to stymie rapid development

 

[dry dre]

Originally posted by theduke
what about robotic surgery? how will that effect the role of the surgeon in the operating room?

Until robots are much more powerful than us I don't think that we will be forced to do surgery on robots. Sorry, I had to. I'm curious about the use of robotics as well. I assume that an MD/DO will always be at the controls manipulating the robot?

On a related note, I'd like to know for how long mid-levels will be prevented from doing procedures like inguinal hernia repairs. It seems to me that there are at least a few procedures that could be conducted by mid-levels with surgeon oversite, similar to the situation with CRNAs. Most surgeons would claim that this simply could never be, but I wouldn't be so sure, particularly with a future of very limited dollars.

 

[mountebank]

i must agree with dry dre, robots are more complicated than many people think. I'm sure it will be at least 10-20 years before a competent physician will complete a robotic fellowship and soley operate on our metal brothers.

 

[droliver]

Originally posted by dry dre
On a related note, I'd like to know for how long mid-levels will be prevented from doing procedures like inguinal hernia repairs. It seems to me that there are at least a few procedures that could be conducted by mid-levels with surgeon oversite, similar to the situation with CRNAs. Most surgeons would claim that this simply could never be, but I wouldn't be so sure, particularly with a future of very limited dollars.

If you've seen how little a surgeon gets paid for a hernia repair you'd realize that there's really no cost savings by an allied health practicioner being trained to do them. This cost is almost zero in systemic analysis of health care costs. The big expenses there are pharmaceuticals, imaging studies, prosthetic devices, supplies, and futile end of life care. Payments to surgeons for care has been squeezed out of relavence for the most part when you look at the expenses with health care.

As far as AHP's doing hernias- you can really hurt people doing hernias (neuromas, testicular ischemia, femoral artery & vein lacerations,bowel injury,etc...). I don't think many people are rushing to hand the potential morbidity of this kind of procedure to undertrained practicioners. More realistic & cost-effective areas for for AHP's to assume care would be skin cancers/pathology & simple wound care , 2 areas which consume large amounts of resources with little morbidity for the treatment in most instances.