Update on the status and future of acute care surgery: 10 years later.
BACKGROUND
Ten years ago, the specialty of trauma surgery was considered to be in crisis. Since then, the Eastern Association for the Surgery of Trauma (EAST) created a position paper, and acute care surgery (ACS) has matured. A repeat survey of EAST members is indicated to evaluate the progress of ACS.


METHODS
A survey was e-mailed to EAST members. Results were evaluated and compared with the previous position paper and survey.


RESULTS
The response rate was 15%. More than three fourths of the respondents were male, and just less than one fourth of them were female. More than half of the respondents were in practice for less than 10 years. Seventy-three percent were involved in research, although only 16% were allotted protected time. Most respondents felt that reimbursement for their effort was inadequate: 54% thought reimbursement was fair for trauma care, 59% for critical care, 49% for nontrauma ACS, and 62% for general surgery. The biggest incentive to a career in ACS was that it was a challenging and exciting activity; the biggest disincentive was working at night. Seventy-two percent expressed satisfaction with their career profile, and 92% were either very or somewhat happy with their career. Sixty-six percent did feel either somewhat or very burned out. Surgeons were interested in learning more about contract negotiation, business/managerial issues, and billing/coding. Compared with the previous survey, overall career satisfaction seems stable.


CONCLUSIONS
Most surgeons are satisfied with a career in ACS. There are still some facets of the career that warrant improvement. Focus on surgeon satisfaction may lead to enhancements in patient care.
From the Division of Acute Care Surgery (M.L.), Rutgers - Robert Wood Johnson Medical School, New Brunswick, New Jersey; Section of Acute Care and Trauma Surgery (R.S.), Boston University School of Medicine, Boston, Massachusetts; Division of Trauma and Surgical Critical Care (A.M.), Vanderbilt University Medical Center, Nashville, Tennessee; Division of trauma, Critical Care and Burns (T.E.), Loyola University Medical Center, Maywood, Illinois; Division of Trauma, Critical Care, Emergency Surgery (T.D.), The Medical College of Virginia/Virginia Commonwealth University School of Medicine, Richmond, Virginia.
Matthew E
ME
Lissauer
Robert
R
Schulze
Addison
A
May
Thomas
T
Esposito
Therese M
TM
Duane
D001291:Attitude of Health Personnel; D002321:Career Choice; D005260:Female; D005544:Forecasting; D013502:General Surgery / Q000639:trends*; D006801:Humans; D008297:Male; D011795:Surveys and Questionnaires; D014194:Traumatology / Q000639:trends*; D014481:United States