Written by Mit Desai, MD FACS, Founder and CEO of The Surgicalist Group

There are certain song lyrics we can’t get out of heads, like Dylan’s, “The Times They are a-Changin’” that came out in 1964, before I was born. The song was an anthem about big changes happening in our country and the world during in the 1960s. The song has been covered by artists over the years from The Beach Boys to Brandi Carlile. It’s a classic and has weathered the test of time and its meaning is well understood.  Okay, but what does this song have to do with acute care surgery?  Everything.  Let me explain…

Following residency, I started a solo practice in 2003. I learned just how grueling the life of a general surgeon would be that first year. You see, general surgeons are pulled in many directions, often all at once: to the office for patient visits and the paperwork, to the hospital for rounds and surgery, to the ambulatory surgery center for elective cases, and to the ER for surgical emergencies. And finally, every surgeon battles the challenges of making time for our families who usually get short-changed more times than any of us would like to admit.

Nearly from the beginning, I felt the pressures of being available 24/7 365 days a year. At the same time, I was observing a few major changes in healthcare. The times they were changing. It was the advent of valued-based care. It was the dawn of internists trading in their practices to become hospitalist, working 12-hour shifts and only working in the hospital. Those changes were inspiring.  I saw hospitalists more engaged than their internist counterparts in the community. They seemed well-rested and sharper somehow. They partnered with hospital administration to bring change to inpatient acute care. Eventually, I found myself fixating how I could create a smarter way to work in general surgery, taking a page from the hospitalists.  Much like Dylan’s earworm song, “a smarter way to operate,” became my personal mantra.

“A smarter way” mantra eventually drove me to turn into a surgeon-entrepreneur.  I wanted to change the way general surgery was practiced. The vision was to get back to what I loved doing – taking care of patients, operating, and making a difference in healthcare. And, I knew other surgeons had similar desires. Instinctively, I knew there had to be a smarter way to care for patients, to partner with the hospital, and to improve life for surgeons.

In 2006, I convinced a small team of like-minded surgeons to join me in Florida. Our team was busy at work, developing new clinical workflows, designing more efficient processes, and applying technology to help manage the “back office” work in a way that was not just better, it was smarter. We were so busy perfecting our model, we didn’t realize that on the other side of the country at UCSF, John Maa, MD, a general surgeon, was attempting a similar approach in an academic medical center. Maa’s pilot project started in 2005. The pilot was designed to bring change that would improve the surgeon’s and patient’s experience. He published the seminal paper on the concept of the surgicalist in 2007. At the same time, our team was tackling smarter ways to improve outcomes for emergent and urgent surgery. Since that time, we’ve made major strides in acute care surgery and continue to innovate.

I hope his introductory story in this first issue of Acute Insights newsletter piqued your interest to learn more about – The Surgicalist Group – The Smarter Way to Operate™. In future issues we’ll share details about the changes we’ve made, inspired by our vision.  Our vision is to transform the way acute care surgery is practiced by ensuring every patient entrusted to our surgicalists receives the right care without delay.


Acute Insights highlights the many aspects of the surgicalist model first-hand from the leaders at The Surgicalist Group.

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