SURGERY FOR RURAL SURGERY FOR RURAL AMERICA AMERICA Thomas H. Cogbill, M.D. Gundersen Lutheran Medical Foundation La Crosse, Wisconsin
SURGERY FOR RURAL SURGERY FOR RURAL AMERICAAMERICA
Thomas H. Cogbill, M.D.
Gundersen Lutheran Medical FoundationLa Crosse, Wisconsin
Gundersen Lutheran Health Gundersen Lutheran Health SystemSystem
Fully IntegratedFully Integrated
Physician-LedPhysician-Led
453 Physicians453 Physicians
6159 Employees6159 Employees
Main Clinic – La Crosse, WisconsinMain Clinic – La Crosse, Wisconsin
(population 51,000)(population 51,000)
12 General Surgeons12 General Surgeons
Branch Clinics – 25 LocationsBranch Clinics – 25 Locations
9 General surgeons9 General surgeons
GL SURGICAL RESIDENCYGL SURGICAL RESIDENCY
Began in 1974Began in 1974
Currently 2 Categorical Positions/YearCurrently 2 Categorical Positions/Year
Only Surgical ResidencyOnly Surgical Residency
Single Fellowship – Bariatric/MISSingle Fellowship – Bariatric/MIS
GL SURGICAL RESIDENCYGL SURGICAL RESIDENCY
Committed to General SurgeryCommitted to General Surgery
High Volume Open CasesHigh Volume Open Cases
High Volume Laparoscopic CasesHigh Volume Laparoscopic Cases
Critical Care – 2 Months (R1/R3)Critical Care – 2 Months (R1/R3)
R4/R5 Trauma Resuscitation LeadersR4/R5 Trauma Resuscitation Leaders
GL SURGICAL RESIDENCYGL SURGICAL RESIDENCY
Obstetrics/Gynecology – 2 Months (R3)Obstetrics/Gynecology – 2 Months (R3)
High Volume Endoscopy – 2 Months High Volume Endoscopy – 2 Months (R3/R4)(R3/R4)
Rural Surgery Elective – (R4)Rural Surgery Elective – (R4)
Practice-Based Learning CurriculumPractice-Based Learning Curriculum
Practice Management Practice Management CurriculumCurriculum
Ethics Grand Rounds (6/year)Ethics Grand Rounds (6/year)
Coding & ReimbursementCoding & Reimbursement
MalpracticeMalpractice
ContractsContracts
Practice ManagementPractice Management
Rural Surgery ElectiveRural Surgery Elective
Prairie du Chien, Wisconsin (pop 6047)Prairie du Chien, Wisconsin (pop 6047)
Decorah, Iowa (pop 7944)Decorah, Iowa (pop 7944)
Anticipated Practice SitesAnticipated Practice Sites
Emphasis on AcademicsEmphasis on Academics
Require 2 PublicationsRequire 2 Publications
Require 2 PresentationsRequire 2 Presentations
Evidence-Based LearningEvidence-Based Learning
GraduatesGraduates
FellowshipFellowship 24%24%
Urban/Large Rural Urban/Large Rural
General SurgeryGeneral Surgery 26%26%
Small Rural General SurgerySmall Rural General Surgery 50%50%
Postgraduate ResponsibilityPostgraduate Responsibility
1.1. Faculty clinical resourceFaculty clinical resource
2.2. CME programsCME programs
3.3. Teaching Teaching
a. ATLSATLS
b. Rural electiveRural elective
Essentials for Rural SurgeryEssentials for Rural Surgery
Strong 5-Year Core General SurgeryStrong 5-Year Core General Surgery
Obstetrics/GynecologyObstetrics/Gynecology
EndoscopyEndoscopy
Surgical SubspecialtiesSurgical Subspecialties
Practice Management CurriculumPractice Management Curriculum
Full Immersion Rural Surgery ElectiveFull Immersion Rural Surgery Elective