So what does a general surgeon do? Simply put, almost everything. As Dr. Gomes explains, general surgeons handle most surgical situations that come through a hospital. “We look after all the big trauma that crosses all the different specialties. If you've been stabbed or you have a bleed into your brain from trauma, the general surgeon will fix it. The leaders of the trauma teams in many Alberta hospitals are general surgeons. We do a lot of things that save people's lives in extreme circumstances.”
General surgeons also handle most cancer surgeries including thyroid cancers, breast cancers, intestinal cancers and melanomas and will triage patients and help make a diagnosis. “Half of the colonoscopies done in Alberta are done by general surgeons,” notes Dr. Gomes. “So if you're screening for colon cancer, there's a good chance you're going to see a general surgeon or a colorectal surgeon, who is a specially trained general surgeon, for your colonoscopy.” In addition, general surgeons do a range of other intestinal work including gallbladder and hernia surgeries.
What’s in a name?
The breadth and depth of the work done by general surgeons has led many to wonder if they shouldn’t consider a name change. Dr. Gomes says, “We've actually had a debate among colleagues across Canada about whether there could be a better name for general surgery. We do so many things that we can't really come up with one that's descriptive enough. When you see shows on TV, they don't say ‘get the general surgeon.’ They say ‘get the trauma surgeon’ or ‘get the emergency surgeon’ or ‘get the vascular surgeon,’ but the fact of the matter is that general surgeons get pulled into doing all of that stuff. It’s just when you say trauma surgeon, it sounds so much better.”
Like many physicians working within our health care system, general surgeons are facing challenges that make it harder to do the work they are trained to do. Dr. Gomes says, “It’s a very broad field, and it's also very high intensity. A lot of sick patients in the emergency room end up being general surgery patients. We always have sick patients pre- or post-op in the intensive care units.” With the growing pressures on emergency rooms, driven in part by a primary care crisis that has resulted in upwards of 650,000 Albertans living without a family doctor, that intensity has increased.
“Not surprisingly, we feel over worked and under appreciated. By the nature of our work, we’re expected to be able to deal with all those emergency things – we cover call at night while doing all the things a general surgeon would do during the day.” A lack of health human resources is one of the biggest challenges currently facing the specialty.
Dr. Gomes explains that the team is essential to general surgeons, who need a resident or a clinical assistant to be able to provide support in the operating room and coverage in other areas of the hospital when the surgeon is operating. “When a general surgeon is by themselves in a particular hospital, it’s simply not safe. It’s a huge frustration when you're a surgeon and you have a problem you know you can fix, but you don't have the support staff with you to be able to safely take that patient to the operating room.”