title: Acute care surgery: trauma, critical care, emergency general surgery … and preventative health?
abstract: BACKGROUND
  Acute care surgeons (ACS) often care for patients with limited access to health care. They may not participate in preventative screenings and interventions (PSIs) such as mammography, colonoscopy, or pneumococcal vaccinations (VAs). We sought to identify barriers to compliance and determine if ACS have an opportunity to facilitate PSI participation.
  
  
  METHODS
  All patients evaluated by an ACS were considered for inclusion in the study. Patients meeting national PSI inclusion criteria were enrolled. Surveys were administered to assess compliance and identify barriers to participation.
  
  
  RESULTS
  The overall compliance rate with PSIs was 57%. Patients without a primary care physician had a compliance rate of 23%. The most common barrier to participation was lack of knowledge of PSI recommendations (42%). Males were less compliant than females (47% vs 62%).
  
  
  CONCLUSIONS
  ACS evaluate a large number of general surgery and trauma patients. The acute care surgeon-patient encounter represents a valuable opportunity for education and improved PSI compliance. Additional research should focus on developing interventional strategies and evaluating their impact on patient outcomes.
authors.affiliation: Department of Graduate Medical Education, Methodist Dallas Medical Center, Dallas, TX, USA. Electronic address: GregHambright@MHD.com.
authors.forename: Greg
authors.initials: G
authors.lastname: Hambright
authors.affiliation: Department of Clinical Research, Clinical Research Institute, Methodist Health System, Dallas, TX, USA.
authors.forename: Vaidehi
authors.initials: V
authors.lastname: Agrawal
authors.affiliation: Department of Graduate Medical Education, Methodist Dallas Medical Center, Dallas, TX, USA.
authors.forename: Phillip L
authors.initials: PL
authors.lastname: Sladek
authors.affiliation: Department of Inverventional Radiology, Radiological Consultants Association, Methodist Dallas Medical Center, Dallas TX, USA.
authors.forename: Suzanne M
authors.initials: SM
authors.lastname: Slonim
authors.affiliation: Department of Graduate Medical Education, Methodist Dallas Medical Center, Dallas, TX, USA.
authors.forename: Michael S
authors.initials: MS
authors.lastname: Truitt
mesh_terms: D000328:Adult; D000368:Aged; D015331:Cohort Studies; D003422:Critical Care / Q000458:organization & administration*; D004638:Emergency Treatment; D005260:Female; D013502:General Surgery / Q000458:organization & administration; D006801:Humans; D033183:Interdisciplinary Communication; D008297:Male; D008403:Mass Screening / Q000458:organization & administration*; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D010819:Physician's Role; D011315:Preventive Medicine / Q000458:organization & administration*; D011446:Prospective Studies; D066231:Surgeons / Q000600:supply & distribution*; D014193:Trauma Centers; D014481:United States; D014947:Wounds and Injuries / Q000601:surgery*
keywords: Acute care surgery; Colonoscopy; Mammography; Pneumococcal vaccinations; Public health screening