Rural General Surgeons' Perspectives Regarding the Provision of Surgical Care to Children.

OBJECTIVE

The volume of surgical care provided to children by general surgeons has decreased over time, which disproportionally impacts rural children. This study aimed to understand factors that influence rural general surgeons' decisions regarding provision of surgical care to children.

DESIGN

Cross-sectional survey of 55 items conducted between February 2023 and March 2024 SETTING: Survey distributed at meetings, ACS communities, social media.

PARTICIPANTS

162 nonpediatric surgery trained general surgeons practicing in rural communities across North America.

RESULTS

Among respondents, median age was 58 years, and 75.9% identified as male and 87.7% as White/Caucasian. While a majority of respondents operated on children, most performed < 20 surgeries per year. Factors reported by surgeons to be most influential regarding their decision to operate on children were personal experience/expertise/training. Availability of a pediatric inpatient unit and proximity to a children's hospital/pediatric surgeons were the next most influential factors. The amount of pediatric surgery exposure during training, feeling this training was adequate, and a greater number of years in practice since completion of training all significantly correlated with comfort in operating on younger patients. The amount of pediatric surgery exposure during training also correlated with the number of surgeries performed per year in children. > 90% of respondents reported that they would have completed additional training in pediatric surgery if it had been available during or after completion of residency. About 3 to 6 months was reported by most respondents as the optimal duration of additional pediatric surgery exposure.

CONCLUSIONS

New training paradigms that increase exposure to pediatric surgery during residency may facilitate rural surgeons' provision of routine surgical care to children and minimize the travel burden currently experienced by rural children who require surgical care.