Rural surgeries

June is National Safety Month. With only 12 months of the year, many months carry with them numerous topics to help us “become aware.” Few would argue safety should be at the forethought of those in the medical profession. After all, it is not only the safety of the patients we must address but also the safety of those we work with, and ultimately ourselves.

As I was pondering how each hospital I have worked at and performed surgery in is constantly working to integrate this concept into their very fabric, I was drawn to an article in the Journal of the American Medical Association.

When I chose to do surgery in a rural area, I was faced with several overwhelming concerns and questions by colleagues with whom I trained. No matter who asked the question, or the way the comment was phrased, the same theme was pedestaled: “Can you have a safe surgery in a rural hospital?”

There seemed to be experts claiming it would be unsafe for patients to have their surgery in hospitals like Colby. They took data from some very high-risk and complex surgeries and felt this was the same for all procedures. What we are now finding out is they were mostly wrong.

This most recent article was researched by the University of Michigan. The article examined more than 1.6 million hospital encounters during a four-year period (2009 to 2013), all related to the four common surgeries performed at small rural hospitals like those in northwest Kansas. Those surgeries are: Removal of the gallbladder, repair of hernias, colon (large bowel) surgery and appendectomies.

Compared to larger hospitals, the rural surgery programs do very well. In fact, not only is it more cost effective to have your surgery at a rural hospital (average of $1,400 savings per surgery) but it is also safer to have your surgery at a rural hospital. All complications, including the really bad ones, are much less at a rural hospital than at a larger hospital.

This new study confirms what all rural surgeons have known for years. We do really good work in our hospitals. However wonderful this news was to me, I realize the success of a hospital surgery program goes far beyond the surgeon. In fact, it has very little to do with the technique and expertise of the surgeon. The true success of a surgery program lies in all those who help to support it on a daily basis. They are the ones constantly looking out for the safety of the surgeons, staff and ultimately the community. Without them, we never could bring big-town surgery to small-town America.

As you go through National Safety Month, I would ask you to reflect on all those individuals who make an extra effort to make your world a safer place. Thank them for their hard work. Believe me, they have earned it.

Kelly Gabel, DO, FACOS,

Northwest Kansas Surgical Associates at Citizens Medical Center,