The Operative Word
In this series the hosts talk to the editors and experts featured in the Journal of the American College of Surgeons (JACS), the official scientific journal of the American College of Surgeons, a monthly peer-reviewed journal publishing original contributions on all aspects of surgery.
Episodes
E45: Patient-Based Decision Making for Opioid Prescriptions After Ambulatory Breast Operation: A Randomized Clinical Trial
In this episode, Thomas K Varghese, Jr, MD, FACS, is joined by Serena Lofftus, MD, and James Wu, MD, FACS, from UCLA. They discuss Drs Lofftus and Wu’s recent article, “Patient-Based Decision Making for Opioid Prescriptions After Ambulatory Breast Operation: A Randomized Clinical Trial,” which evaluated whether incorporating patient choice into postoperative prescribing decisions could reduce opio
E44: Whether and How Surgeons Took Action Against Workplace Microaggression: Survey of American College of Surgeons Members
In this episode, Lillian Erdahl, MD, FACS, is joined by Pringl Miller, MD, FACS, from Physican Just Equity, and Christine Heisler, MD, FACS, from the Mayo Clinic Health System. They discuss Drs Miller and Heisler’s recent article, “Whether and How Surgeons Took Action Against Workplace Microaggression: Survey of American College of Surgeons Members,” in which the authors found that the most freque
E43: Development, Validation, and Comparison of Machine Learning Models for Predicting Pediatric Surgical Site Infection Using the NSQIP-P Database
In this episode, Thomas K Varghese, Jr, MD, FACS, is joined by Carrie Chan, MSN, MPH, from the University of California, San Francisco, and Karthik Balakrishnan, MD, FACS, from Stanford Medicine Children’s Health. They discuss their recent article,“Development, Validation, and Comparison of Machine Learning Models for Predicting Pediatric Surgical Site Infections Using the NSQIP-P Database,” which
E42: Results of an American College of Surgeons Prospective National Quality Improvement Collaborative to Successfully Overcome Barriers to Cancer Care Across the US
In this episode, Thomas K Varghese, Jr, MD, FACS, is joined by Laurie J Kirstein, MD, FACS, from Memorial Sloan Kettering. They discuss Dr Kirstein’s recent article, “Results of an American College of Surgeons Prospective National Quality Improvement Collaborative to Successfully Overcome Barriers to Cancer Care Across the US,” in which 194 American College of Surgeons (ACS)-accredited cancer prog
E41: Identifying Diagnostic Gaps and Mitigation Strategies for Older Adult Emergency General Surgery Patients: A Scoping Review
In this episode, Lillian Erdahl, MD, FACS, is joined by Jessica Liu, MD, MS, MPH, from the Department of Surgery, Harbor UCLA Medical Center. They discuss Dr Liu’s recent article, “Identifying Diagnostic Gaps and Mitigation Strategies for Older Adult Emergency General Surgery Patients: A Scoping Review,” in which the authors identified the current diagnostic issues, clinical tools, and clinician f
E40: From Surgeon Well-Being to Artificial Intelligence: 2025 Highlights
In this episode, JACS Editor-in-Chief Tom Varghese, MD, FACS, and Digital Media Editor Lillian Erdahl, MD, FACS, review 6 impactful articles from the past year, highlighting key themes shaping modern surgical practice. Dr Erdahl focuses on the surgeon as a subject, discussing research on moral distress, second-victim syndrome, health policy challenges, and peer surgical coaching. Dr Varghese then
E39: Postoperative Pain Management in the US vs Low- and Middle-Income Countries by US Surgeons
In this episode, Tom Varghese, MD, FACS, is joined by Ziad Sifri, MD, FACS, from Rutgers New Jersey Medical School, and Matthew Linz, MD, from Rutgers Robert Wood Johnson Medical School. They discuss Drs Sifri and Linz’s recent article, “Postoperative Pain Management in the US vs Low- and Middle-Income Countries by US Surgeons,” in which they found that surgeons in the US prescribe significantly m
E38: What About the Coach? Mixed-Methods Study Assessing the Experience of Coaches in a Peer Surgical Coaching Program
In this episode, Lillian Erdahl, MD, FACS, is joined by Eilidh Gunn, MBChB MRCSEd, from the Surgical
Sabermetrics Laboratory at the University of Edinburgh. They discuss Dr Gunn’s recent article, “What About the Coach? Mixed-Methods Study Assessing the Experience of Coaches in a Peer Surgical Coaching Program.” As peer-led surgical coaching becomes an increasingly popular professional development
E37: Expanding the Public Health Role of Pediatric Trauma Centers: Drug Screening for Adolescent Trauma Patients
In this episode, Lillian Erdahl, MD, FACS, is joined by Jordan Rook, MD, from UCLA, and Lorraine Kelley-Quon, MD, FACS, from Children’s Hospital Los Angeles and Keck School of Medicine of USC. They discuss Drs Rook and Kelley-Quon’s recent article, “Expanding the Public Health Role of Pediatric Trauma Centers: Drug Screening for Adolescent Trauma Patients,” in which the authors found that biochemi
E36: Association of Discharge Against Medical Advice with Surgical Outcomes and Healthcare Cost
In this episode, Tom Varghese, MD, FACS, is joined by Timothy Pawlik, MD, FACS, from The Ohio State University. They discuss Dr Pawlik’s recent article, “Association of Discharge Against Medical Advice with Surgical Outcomes and Healthcare Cost,” in which the authors found that discharge against medical advice (DAMA) among surgical patients is associated with increased 30-day readmission, complica
E35: Association of State Helmet Laws with Helmet Use and Injury Outcomes in Motorcycle Crashes
In this episode, Lillian Erdahl, MD, FACS, is joined by Stephanie M Jensen, MD, MPH, and A Britt Christmas, MD, MBA, FACS, from the Carolinas Medical Center, Charlotte, NC. They discuss the recent article by Drs Jensen and Christmas, “Association of State Helmet Laws with Helmet Use and Injury Outcomes in Motorcycle Crashes,” in which the authors analyzed a decade of motorcycle collision data from
E34: Evaluating Outcomes of Initial Site Visits Across American College of Surgeons Accreditation Programs
In this episode, Tom Varghese, MD, FACS, is joined by Brett Johnson, MD, and Clifford Ko, MD, FACS, from the American College of Surgeons (ACS). They discuss the recent article by Drs Johnson and Ko, “Evaluating Outcomes of Initial Site Visits Across American College of Surgeons Accreditation Programs,” in which the authors found that ACS accreditation identifies significant gaps in hospital quali
E33: Limited or Lasting: Is Preoperative Weight Loss as Part of Prehabilitation Maintained after Open Ventral Hernia Repair?
In this episode, Tom Varghese, MD, FACS, is joined by Todd Heniford, MD, FACS, and Alexis Holland, MD, from the Carolinas Medical Center. They discuss the recent article by Drs Heniford and Holland, “Limited or Lasting: Is Preoperative Weight Loss as Part of Prehabilitation Maintained after Open Ventral Hernia Repair?” This study supports the implementation of preoperative optimization and weight
E32: Validation of Artificial Intelligence-Based POTTER Calculator in Emergency General Surgery Patients Undergoing Laparotomy: Prospective, Bi-Institutional Study
In this episode, Tom Varghese, MD, FACS, is joined by Haytham Kaafarani, MD, MPH, FACS, and Vahe Panossian, MD, from the Department of Surgery, Massachusetts General Hospital and Harvard Medical School. They discuss the recent article by Drs Kaafarani and Panossian, “Validation of Artificial Intelligence-Based POTTER Calculator in Emergency General Surgery Patients Undergoing Laparotomy: Prospecti
E31: American College of Surgeons Cancer Programs Annual Report from 2021 Participant User File
In this episode, Lillian Erdahl, MD, FACS, is joined by Judy Boughey, MD, FACS, from the Mayo Clinic Rochester Department of Surgery. They discuss Dr Boughey’s recent article, “American College of Surgeons Cancer Programs Annual Report from 2021 Participant User File.” This inaugural annual report from the National Cancer Database describes the 2021 adult participant user files (PUF) as a whole, a
E30: Cost-Effectiveness of Nonoperative Management vs Upfront Laparoscopic Appendectomy for Pediatric Uncomplicated Appendicitis Over 1 Year
In this episode, Lillian Erdahl, MD, FACS, is joined by Peter C Minneci, MD, FACS, MHSc, from the Department of Surgery, Nemours Children’s Health, Delaware Valley. They discuss Dr Minneci’s recent article, “Cost-Effectiveness of Nonoperative Management vs Upfront Laparoscopic Appendectomy for Pediatric Uncomplicated Appendicitis Over 1 Year,” in which the authors found that cost-effectiveness of
E29: Refractory and Recurrent Idiopathic Granulomatous Mastitis Treatment: Adaptive, Randomized Clinical Trial
In this episode, Lillian Erdahl, MD, FACS, is joined by Fatemeh Shojaeian, MD, MPH, from the Johns Hopkins University School of Medicine. They discuss Dr Shojaeian’s recent article, “Refractory and Recurrent Idiopathic Granulomatous Mastitis Treatment: Adaptive, Randomized Clinical Trial,” in which the authors found that, for resistant or relapsing patients with idiopathic granulomatous mastitis,
E28: Protective Effects of Authenticity Against Depression, Suicide, and Burnout among Surgeons
In this episode, Lillian Erdahl, MD, FACS, is joined by Jessica Ching, MD, from the Baylor College of Medicine. They discuss Dr Ching’s recent article, “Protective Effects of Authenticity Against Depression, Suicide, and Burnout among Surgeons,” in which the authors found that authenticity may protect against burnout, depression, and suicide, pointing to a vital intervention opportunity. This rese
E27: Association of Daily Step Count and Postoperative Complication among All of Us Research Participants
In this episode, Tom Varghese, MD, MS, MBA, FACS, is joined by Anai N Kothari MD, FACS, MS, FSSO, from the Medical College of Wisconsin. They discuss Dr Kothari’s recent article, “Association of Daily Step Count and Postoperative Complication among All of Us Research Participants,” in which the authors used preoperative wearable device data from 475 patients to investigate the link between daily s
E26: Contemporary Evaluation of Work-Life Integration and Well-being in US Surgical Residents: A National Mixed-Methods Study
In this episode, Tom Varghese, MD, MS, MBA, FACS, is joined by Lauren M Janczewski, MD, MS, from Northwestern University, and Yue-Yung Hu, MD, MPH, FACS, from the Ann & Robert H. Lurie Children’s Hospital and Northwestern Quality Improvement, Research, and Education in Surgery (NQUIRES). They discuss their recent article, “Contemporary Evaluation of Work-Life Integration and Well-being in US S
E25: Association of National Accreditation Program for Rectal Cancer Accreditation with Outcomes after Rectal Cancer Surgery
In this episode, Tom Varghese, MD, FACS is joined by Calista M Harbaugh, MD, MSc, from the University of Michigan. They discuss Dr Harbaugh’s recent study, “Association of National Accreditation Program for Rectal Cancer Accreditation with Outcomes after Rectal Cancer Surgery,” in which the authors found that hospitals accredited by the National Accreditation Program for Rectal Cancer are associat
E24: Sustaining Lifelong Competency of Surgeons: Multimodality Empowerment Personal and Institutional Strategy
In this episode, Lillian Erdahl, MD, FACS is joined by Todd Rosengart, MD, FACS, from the Baylor College of Medicine. They discuss Dr Rosengart’s recent article, “Sustaining Lifelong Competency of Surgeons: Multimodality Empowerment Personal and Institutional Strategy,” which focuses on maintaining and ensuring the competency of an aging surgeon workforce. The study provides evidence-based guiding
E23: Home Is Not Always Where the Sleep Is: The Effect of Home Call on Sleep, Burnout, and Surgeon Well-Being
In this episode, Tom Varghese, MD, FACS is joined by Jamie Coleman, MD, FACS, from the University of Louisville. They discuss Dr Coleman’s recent article, “Home Is Not Always Where the Sleep Is: The Effect of Home Call on Sleep, Burnout, and Surgeon Well-Being”, which quantifies sleep loss and burnout associated with home call in acute care surgeons, emphasizing that there are both physical and em
E22: Expeditionary Surgeons: Essential to Surgical Leadership in World War II and Today
In this episode, Tom Varghese, MD, FACS is joined by Jeremy Cannon, MD, SM, FACS, from the University of Pennsylvania. They discuss Dr Cannon’s Excelsior Surgical Society Presidential Address, emphasizing the crucial contribution of expeditionary surgical leaders in World War II and how their legacy serves as an example for military and civilian surgeons seeking to lead in austere settings today.
E21: Social Determinants of Outcomes Disparity among Pediatric Solid Tumor Patients
In this episode, Lillian Erdahl, MD, FACS is joined by Dai Chung, MD, FACS, from the University of Texas Southwestern Medical Center. They discuss Dr Chung’s recent study, which demonstrates that poor health outcomes among pediatric solid tumor patients are associated with minority race and residence in rural or border regions, and that the 5-year rate mortality rises with increasing area deprivat
E20: Anchors Aweigh! The History of Women Surgeons at Sea
In this episode, Lillian Erdahl, MD, FACS is joined by Amy Hernandez, MD, FACS, from the Department of Surgery, Naval Medical Center San Diego. They discuss Dr Hernandez’s recent study, which uses literature review, personal interviews, and correspondence with Navy Medicine administrative leaders to describe the evolution of women providing surgical care at sea.
Disclosure Information: Drs Erdah
E19: Practical and Ethical Guidelines for the Involvement of Trainees in Global Surgery:
In this episode, Lillian Erdahl, MD, FACS, is joined by Erin M Scott, MD, MPH, from the University of Massachusetts Chan Medical School. They discuss Dr Scott’s recent study, which outlines recommendations of the American College of Surgeons Resident and Associate Society Global Surgery Work Group for involvement of trainees in global surgery, with an aim to support equitable, sustainable collabor
E18: Diverticulitis Familiality: A Statewide Case-Control Study
In this episode, Dr Tom Varghese is joined by Jessica Cohan, MD, FACS, from the University of Utah. They discuss Dr Cohan’s recent study, which used statewide medical records linked with genealogy data to evaluate the familial contributions to diverticulitis. The results indicate that diverticulitis has a significant heritable component, which may inform surgeons as they counsel family members abo
E17: Novel Form of Breast Intraoperative Radiation Therapy with CT-Guided High-Dose-Rate Brachytherapy: Interim Results of a Prospective Phase II Clinical Trial
In this episode, Dr Jamie Coleman is joined by Shayna Showalter, MD, from the University of Virginia School of Medicine, Charlottesville, VA. They discuss Dr Showalter’s recent study evaluating precision breast intraoperative radiation therapy (PB-IORT), which uses customized CT-based treatment plans for high-dose-rate (HDR) brachytherapy. Interim results show that PB-IORT has an acceptable breast
E16: Comprehensive Cost Implications of Commercially Available Noninvasive Colorectal Cancer Screening Modalities
In this episode, Dr Dante Yeh is joined by Casey Allen, MD, from the Institute of Surgery, Division of Surgical Oncology, Allegheny Health Network, Pittsburgh, Pennsylvania. They discuss Dr Allen’s recent study, which found that widespread adoption of the fecal immunochemical test for noninvasive colorectal cancer screening could lead to substantial cost savings. This carries major value implicati
E15: Operationalizing the Culture of Burnout and Well-Being: Multicenter Study of Value Congruence and Flourishing in General Surgery Residency
In this episode, Dr. Jamie Coleman is joined by Carter Lebares, MD, FACS, from the Department of Surgery, University of California San Francisco. They discuss Dr. Lebares’ recent study at 16 academic general surgery training programs, in which residents indicated a perceived lack of value congruence with leadership regarding occupational well-being. Program directors expressed variable alignment w
E14: Leadership and Imposter Syndrome in Surgery
In this episode, Dr Dante Yeh is joined by Lola Fayanju, MD, MA, MPHS, FACS, from The University of Pennsylvania, Philadelphia, PA. They discuss Dr Fayanju’s recent study on imposter syndrome, an internalized sense of incompetence and not belonging. The study found that female physicians were more likely to experience imposter syndrome than male physicians, regardless of specialty or leadership ro
E13: Quantifying the Prognostic Value of Preoperative Surgeon Intuition: Comparing Surgeon Intuition and Clinical Risk Prediction as Derived from the American College of Surgeons NSQIP Risk Calculator
In this episode, Dr Dante Yeh is joined by Gabriel Brat, MD, FACS, MPH and Jayson Marwaha, MD, MBI, from Beth Israel Deaconess Medical Center, Boston, MA. They discuss their recent study, which compared the predictive utility of preoperative surgeon intuition and surgical risk calculators and found that, while preoperative surgeon intuition alone is an independent predictor of patient outcomes, tr
E12: COVID Vaccination Status and Operative Outcomes after Kidney Transplantation
In this episode, Dr Jamie Coleman is joined by Bradley Kushner, MD, from the Washington University School of Medicine, St Louis. They discuss Dr Kushner’s study, which found that patients who are unvaccinated against COVID-19 have worse compliance and healthcare follow-up after a kidney transplant compared with those who were preoperatively vaccinated.
Disclosure Information: Drs Kushner and Col
E11: Severe Increase in Nursing Labor Cost and Effect on Surgical Department Financial Margins at an Academic, Tertiary Medical Center
In this episode, Dr Jamie Coleman is joined by Clayton Brinster, MD, FACS, from Ochsner Health. They discuss his study, which demonstrates a significant increase in surgical nursing labor cost, with a resultant decrease in department of surgery financial margins. This nationwide, precarious trend is not sustainable, and fiscal recovery will require sustained, strategic workforce allocation.
Disclo
E10: Truth of Colorectal Enhanced Recovery Programs: Process Measure Compliance in 151 Hospitals
In this episode, Dr. Dante Yeh is joined by Tejen Shah, MD, from The Ohio State University Wexner Medical Center. They discuss his study, which shows that contrary to published enhanced recovery program (ERP) literature, most study hospitals had difficulty improving process compliance, with 80% not achieving substantial improvement. ERP bundles should be implemented in a more deliberate manner wit
E9: Fluoroscopic Intraoperative Breast Neoplasm and Node Detection
In this episode, Dr Jamie Coleman is joined by Roi Weiser, MD, from the University of Texas MD Anderson Cancer Center, and Suzanne Klimberg, MD, PhD, MSHCT, FACS, from the Division of Surgical Oncology at the University of Texas Medical Branch. They discuss their study, which shows that fluoroscopic intraoperative neoplasm and node detection (FIND) can be used to localize the biopsy clip marking a
E8: Cost Effectiveness of Universal Screening for Blunt Cerebrovascular Injury: A Markov Analysis
In this episode, Dr Dante Yeh is joined by Sharven Taghavi, MD, MPH, MS, FACS, from the Tulane University School of Medicine. They discuss his study on blunt cerebrovascular injury (BCVI), which is a significant cause of morbidity and mortality in patients with blunt trauma. Using a Markov decision analysis, the authors found that universal screening for cerebrovascular injury using CT angiography
E7: Disparity-Sensitive Measures in Surgical Care: A Delphi Panel Consensus
In this episode, Dr Jamie Coleman is joined by Elzerie de Jager, MBBS(Hons), PhD, from the University of Vermont and the Center for Surgery and Public Health, Department of Surgery, Brigham and Women’s Hospital, Harvard Medical School and Harvard TH Chan School of Public Health; and LD Britt MD, MPH, FACS, from the Department of Surgery, Eastern Virginia Medical School. They discuss their study, i
E6: Permanent vs Absorbable Mesh for Ventral Hernia Repair in Contaminated Fields
In this episode, Dr Dante Yeh is joined by Flavio Malcher, MD, MSc, from the Department of Surgery at New York University. They discuss his study, which validates the findings of recent randomized controlled trials in a larger multicenter cohort, suggesting that permanent mesh is the ideal prosthetic to enhance ventral hernia repair even in contaminated fields, which challenges a longstanding surg
E5: Core Entrustable Professional Activities for Entering Residency: A National Survey of Graduating Medical Student Self-Assessed Skills by Specialty
In this episode, Dr Coleman is joined by Dorothy Andriole, MD, FACS, who is a surgeon and the Senior Director of Medical Education Research at the Association of American Medical Colleges, and Jonathan Amiel, MD, who is a professor of psychiatry and Senior Associate Dean for Innovation in Health Professions Education at Columbia University. They discuss their recent study, which found that many gr
E4: Analyzing Impact of Multimorbidity on Long-Term Outcomes after Emergency General Surgery: A Retrospective Observational Cohort Study
In this episode, Dr. Yeh is joined by Claire Rosen, MD, from the Hospital of the University of Pennsylvania. They discuss her recent paper, which demonstrates that past medical history, specifically multimorbidity, influences the risk of adverse outcomes after emergency general surgery, from increased mortality to limited independence and function. When surgeons understand and communicate these ri
E3: Long-Term Outcomes after Adolescent Bariatric Surgery
In this episode, Dr Coleman is joined by Nestor F De la Cruz-Muñoz Jr, MD, Professor of Surgery and Section Chief of Bariatric Surgery at the University of Miami. They discuss his recent study, which demonstrates the lasting, positive impact of bariatric surgery even decades later, and confirms that bariatric surgery should not be denied to adolescents struggling with morbid obesity.
de la Cruz-
E2: Use of Direct Oral Anticoagulant and Associated Bleeding and Thrombotic Complication after Lower Extremity Bypass
In this episode, Dr. Yeh is joined by lead author Danielle C. Sutzko, MD, MS, from the University of Alabama at Birmingham, and senior author Andrea T. Obi, MD, FACS, from the University of Michigan, both vascular surgeons. They discuss their recent work on outcomes associated with direct oral anticoagulant and vitamin K antagonist use after lower extremity bypass.
Sutzko, Danielle C MD, MS; Kim
E1: Mass Shootings in America: Consensus Recommendations for Healthcare Response
In the inaugural episode, hosts Jamie Coleman, MD, FACS, and Dante Yeh, MD, FACS, speak with Craig Goolsby, MD, MEd, FACEP, Professor and Vice Chair of Emergency Medicine at the Uniformed Services University of the Health Sciences and Science Director at the National Center for Disaster Medicine and Public Health in Bethesda, MD about his group’s latest research, which was conducted using a Delphi
