ACS publishes workplace standards framework to more effectively manage surgeons

The American College of Surgeons (ACS) has released what it calls the first national framework that outlines measurable workplace standards for surgeons. The framework, “Developing Specialty-Specific Workplace Standards for Surgeons,” was published in the Journal of the American College of Surgeons (JACS).

ACS states that the demands placed on surgeons, including long hours, unpredictable schedules and significant administrative responsibilities, can lead to burnout and workforce attrition. Its goal with the framework is to set formal parameters that define sustainable clinical practice for surgeons in order to enhance “surgeon well-being, patient safety, and workforce sustainability.”

The framework provides measurable standards that can be customized by surgical specialty and incorporated into departmental policies, employment contracts, and professional society guidance, states ACS.

“Our goal was to create guidance that would align surgeon well-being with patient safety and system efficiency, while promoting career longevity and workforce stability within the surgical profession,” says lead author Douglas E. Wood, MD, FACS, FRCSEd, ACS Board of Regents Vice-Chair, and The Henry N. Harkins Professor and Chair in the Department of Surgery at the University of Washington. “We want to help ensure that we create a workplace environment that allows us to continue providing excellent care, while also attracting a new generation of the best and brightest into the profession.”

Among the recommendations in the framework, which ACS says is adaptable across surgical disciplines:

• Define limits for frequency and intensity of call coverage using a data-driven approach.
• Recommend appropriate OR and clinic time for full-time surgeons, tailored by specialty.
• Establish appropriate staffing, infrastructure, and technology to support safe, efficient surgical care.
• Define safe patient coverage thresholds based on acuity and team structure.
• Promote policies that reduce fatigue and improve surgeon well-being, including flexibility after high-intensity call periods, which should be recognized as patient safety measures rather than discretionary wellness benefits.
• Support fair compensation for required non-clinical training and administrative responsibilities.

The framework “draws upon existing literature, benchmarks from other specialties, and input from practicing surgeons and health system leaders,” states ACS, which adds that it has had “formal conversations with more than a dozen other medical associations, all of which are preparing their own manuscripts using the ACS framework as the foundational document.”

“The long-term sustainability of the surgical workforce requires a cultural and operational shift from informal expectations to transparent standards that support the critical work of surgeons across all specialties,” says Patricia L. Turner, MD, MBA, FACS, ACS’ executive director and CEO, and co-author of the article. “Clear workplace standards will support patient safety, improve retention, and create accountability around workload, resources, and compensation.”

Read the full JACS article about the framework here.