[Editor’s note: The following opinion article is the first in a series by leaders of the American Society of General Surgeons, an organization that advocates for general surgeons. Articles in this series will focus on practical advice about navigating nonclinical aspects of running a general surgical practice.]

In the first line of the first article in a series of future articles brought to you by the American Society of General Surgeons (ASGS), I want to congratulate you. You have not given up. You are still engaged. Your time is limited, your stress is high, and the demands on you to be a general surgeon, a spouse, a parent and even just a decent human being never seem to diminish. Yet you are taking the time to quickly glance at an article written by one of your colleagues anticipating that there may be some nugget of insight in there that you can quickly absorb while gulping that last bit of coffee before the next case/patient/appointment/meeting that you are late for. You hope that there will be a sentence or a web link in there that will make your life as a general surgeon, a spouse, a parent and a human just a little bit easier. I think you will.

My two-year adventure as the president of the ASGS has demonstrated to me that the environment you and I try to practice in has spiraled out of our control. That is a very unsettling feeling for a surgeon, as we tend to be predisposed to assuming we know everything and are in control of the situations and the risks we encounter as they pertain to our practice.

The confidence that we can handle adversity was drilled into our psyche during the surgical education that we all survived. The core training that we all received in residency serves us well in the area of patient care. Unfortunately, our training did not include terms such as CPT (Current Procedural Terminology), ICD-10 (International Classification of Diseases, 10th Revision), MOC (Maintenance of Certification), NSQIP (the National Surgical Quality Improvement Program), MACRA (Medicare Access and CHIP Reauthorization Act of 2015), restrictive covenants, CMO (the Care Management Company), PCMH (patient-centered medical home), hospital employment, sunshine laws, social media, SEO (search engine optimization), branding, surgicalist, etc.

The list goes on, and each of us could likely add several of our personal favorite stress-generating acronyms. I know that my head nearly exploded when one of my hospitals began to enforce the new “mandatory” guidelines for what I can wear on my head in the operating room (OR) based on the recommendations of another entity that didn’t ask me for my opinion or yours. When I inquired, pleasantly with a forced smile on my face, about why this was necessary, I was told that this regulatory body was concerned about “ear dander” creating infections. I am not making this up.

To be continued…

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