Rural General Surgery: A 38-Year Experience with a Regional Network Established by an Integrated Health System in the Midwestern United States.

Background: General surgeon (GS) workforce shortages are predicted to worsen, particularly in rural areas. We report on a sustainable model for delivery of GS services within a large rural region that includes an integrated health system.

Study Design: We conducted a longitudinal study of a rural GS network from 1978 to 2016.

Improving a regional outreach program in a large health system using geographic information systems.

As government-insured populations grow, commercially insured populations decrease, and declining insurance reimbursements pressure cost and revenue. Health systems must strive to improve quality while lowering costs. Large medical centers with rural sites must understand their geography and how distances impede access to services, thereby affecting patient health.

Long-term follow-up of the modified Delorme procedure for rectal prolapse.

Hypothesis: The modified Delorme operation is a safe, effective, and durable treatment for complete rectal prolapse.

Design: Retrospective analysis of outcomes in adult patients undergoing the modified Delorme operation.

Setting: Community-based tertiary referral center with a 5-year general surgery residency program.