Abstract:
The past 50 years have witnessed profound changes in the specialty of pediatric surgery in North America. There has been a marked increase in the number of both pediatric surgical training programs and practicing pediatric general and thoracic surgeons. Despite this trend, the population of children in the United States and the birth rate have recently remained relatively flat. Some pediatric surgeons have become \"super specialists\", concentrating their practices in oncology or colorectal surgery. This has the potential to result in a dilution of experience for both pediatric surgical trainees and practicing pediatric surgeons, thus limiting their ability to acquire and maintain expertise, respectively. Coincident with this, there has been a relative paradigm shift in recognition that \"quality of life\" is based more on maintaining a creative balance in lifestyle and is not \"all about work\". There has been a parallel growth in the number of practicing pediatric general and thoracic surgeons in urban settings, but we have not appreciated as much growth in rural and underserved areas, where access to pediatric surgical care remains limited and fewer pediatric general and thoracic surgeons practice. This is a complex issue, as some underserved areas are economically depressed and geographically sparse, but others are just underserved with adult providers taking care of children in settings that are often under resourced for pediatric surgical care. This problem may extend beyond the boundaries of pediatric general and thoracic surgery to other specialties. As the premier association representing all pediatric surgeons in the United States, the American Pediatric Surgical Association (APSA) has concluded that the quality of pediatric surgical care will likely decline should the status quo be allowed to continue. Therefore, APSA has initiated a Right Child/Right Surgeon initiative to consider these issues and propose some potential solutions. What follows is a brief statement of intent.
摘要:
在过去的50年中,北美儿科外科专业发生了深刻的变化。儿科外科培训计划和执业儿科普通和胸外科医师的数量均显着增加。尽管有这种趋势,美国的儿童人口和出生率最近保持相对平稳。一些儿科外科医生已经成为“超级专家”,将他们的实践集中在肿瘤学或结直肠手术中。这有可能导致儿科外科学员和儿科外科医生的经验稀释,从而限制了他们获得和保持专业知识的能力,分别。与此相吻合,人们认识到,“生活质量”更多的是基于保持生活方式的创造性平衡,而不是“所有关于工作”,这已经发生了相对的范式转变。在城市环境中,执业儿科普通和胸外科医师的数量同时增长,但是我们没有意识到农村和服务不足地区的增长,在那里,获得儿科外科护理的机会仍然有限,儿科普通和胸外科医师的实践较少。这是一个复杂的问题,由于一些服务不足的地区经济不景气,地理位置稀少,但其他人只是服务不足与成人提供者照顾儿童的环境,往往是在儿科外科护理资源不足。这个问题可能会超出儿科普通和胸外科的范围,扩展到其他专业。作为代表美国所有儿科外科医生的首要协会,美国小儿外科协会(APSA)得出结论,如果现状继续下去,小儿外科护理的质量可能会下降.因此,APSA发起了一项权利儿童/权利外科医生倡议,以考虑这些问题并提出一些潜在的解决方案。以下是一个简短的意图声明。