The end of surgery?

[Tristero]

I was going through some biotech articles a friend sent me and found this one to be pretty interesting. It talks about how surgery will become obsolete with the application of pharmacogenetics and proteomics, in a 20 yearish time frame, the article was written in 1999:

It quotes Randall Tobia, former CEO of Eli Lilly corporation:
"The day will come when we regard all surgeries, except trauma, as failures of the pharmaceutical industry. "

http://future.newsday.com/2/fmed7.htm

Anyways, I thought it was overoptimistic BS, but I was wondering what you guys think will be the effect on surgeons as drugs are used to tackle problems that nowadays are in the realm of surgery.
Food for thought.

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[Celiac Plexus]

I was going through some biotech articles a friend sent me and found this one to be pretty interesting. It talks about how surgery will become obsolete with the application of pharmacogenetics and proteomics, in a 20 yearish time frame, the article was written in 1999:

It quotes Randall Tobia, former CEO of Eli Lilly corporation:
"The day will come when we regard all surgeries, except trauma, as failures of the pharmaceutical industry. "

http://future.newsday.com/2/fmed7.htm

Anyways, I thought it was overoptimistic BS, but I was wondering what you guys think will be the effect on surgeons as drugs are used to tackle problems that nowadays are in the realm of surgery.
Food for thought.

In other words, do we think that you should go into surgery? lol....

 

[Tristero]

Man, I'll do surgery either way, balls to the wall. I just wanted to know what you guys thought.

 

[Mirror Form]

Anyways, I thought it was overoptimistic BS, but I was wondering what you guys think will be the effect on surgeons as drugs are used to tackle problems that nowadays are in the realm of surgery.
Food for thought.

Overoptimistic BS is far too kind of a way to describe that junk. I think *****ic, ******ed, or just plain idiotic would be more accurate words to use.

Does he plan on genetically engineering people to have bigger breasts and perfect eye sight? Does he really think we're just going to cure cancer that easily? Maybe this stuff will come around in a couple hundred years, but to suggest that this stuff will happen in our life times is pretty far fetched.

 

[Pilot Doc]

Man, I'll do surgery either way, balls to the wall. I just wanted to know what you guys thought.

So you are saying you would knowingly trade five years of your life for a career that will become obsolete and fail to support your family? That doesn't sound very smart.

It's OK to question the future of surgery. Smart people don't set themselves up to fail, and they have no qualms admitting that. I'm a 2nd year surgery resident - if I thought surgery would be obsolete in 15 years, I'd quit tomorrow.

But I don't believe the pharmaceutical companies rosy predictions. Macroscopic mechanical processes (hernias, bowel obstructions etc.) are hard to treat with drugs. Drug delivery requires a good capillary network - something missing in abscesses, diabetic feet, etc. There are any number of diseases for which no one will spend $5 billion developing a pharmaceutical smart bomb. As medical management keeps people alive longer, they will require more operations.

People will always need surgeons. The question is whether the supply of surgeons will ever significantly exceed demand. It happened to cardiac surgery - it could happen to general surgery too. I don't see anything threatening to do that soon, though.

 

[VentdependenT]

Hernia's, gallbladders, appy's, and trauma will never ever go away....neither will bleeding a$$holes or people vomiting up blood or abdominal pain.

 

[Celiac Plexus]

Yeah like some biotech company is gonna spend 10 years and billions of dollars developing some nanotech pharmaceutical treatment for perirectal abscess.... not when the surgeon on call will come in and do it for a coupla hundred bucks. lol.

 

[Paulista]

Surgery is Megatechnology!

Did you ever realize Surgeons won't be out of job anytime soon.

Surgeons open, fix and close..this is why we do and this is what we have been doing for the past 5 centuries or even longer!

Too many people talk cheap journalism all the time and bring about some doubt. Every morning when you get up to see your patient and change dressings.. I really don't think this would change..unfortunately...

Even with the implementation of national preventive medicine and all other schemes, I still see many cases of advanced colon cancer. Plenty of work out there if you are interesting in help humanity and paying your mortgage and more.

One word about subspecialty training, I have friends who have gone rushing behind the laparoscopic craze and what they have missed is some good basic general surgical training. Many don't even know how to perform many classic procedures J pouch and Total gastrectomies, Whipples. They run behind the wave of technology and they forget the basics are the most important in the career of future surgeon.

 

[Apollyon]

Hernia's, gallbladders, appy's, and trauma will never ever go away....neither will bleeding a$$holes or people vomiting up blood or abdominal pain.

What about GI? They've slowly and quietly (or not so slowly or quietly) taken these once "slam-dunk" cases from surgeons. Of course, the reason why the person has melena/hematochezia or hematemesis has bearing (I don't think GI guys will be resecting hemorrhoids anytime soon, but injecting above the dentate line is not out of reasonable thought), but, for the stuff they can do, they are doing it.

 

[VentdependenT]

True, but who gets consulted? Zee surgeon.

 

[Apollyon]

True, but who gets consulted? Zee surgeon.

But therein lies the rub - if the consult doesn't get called (because GI is doing the procedure), then, well...

 

[VentdependenT]

They'll still probably want the poor surgeon to scuttle down to the ER to do the initial evaluation on the patient. What GI doc is going to want to come in at 3am to fix a massive GI bleed?

I jest. Sort of.

 

[Celiac Plexus]

What about GI? They've slowly and quietly (or not so slowly or quietly) taken these once "slam-dunk" cases from surgeons. Of course, the reason why the person has melena/hematochezia or hematemesis has bearing (I don't think GI guys will be resecting hemorrhoids anytime soon, but injecting above the dentate line is not out of reasonable thought), but, for the stuff they can do, they are doing it.

Hey man, if some GI guy wants to take care of some 'roids for me (and not consult surgery), then God bless him!

That, of course is a resident perspective, however even in private practice, the guy can "take" all the 'roid cases he wants from me. Though realistically, if you were the GI guy, you are probably not gonna do any 'roid work because you'll want to keep your surgeon happy... Consults go both ways, and there are many GI consults to distribute... Ahhh... politics.