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Pro-con debate on regionalization of emergency general surgery: controversy or common sense?
  1. Heena Santry1,
  2. Lillian S Kao2,
  3. Shahid Shafi3,
  4. Lawrence Lottenberg4,
  5. Marie Crandall5
  1. 1Department of Surgery and Center for Surgical Health Assessment, Research and Policy, Ohio State University, Columbus, Ohio, USA
  2. 2Surgery, McGovern Medical School at University of Texas Health Science Center at Houston, Houston, Texas, USA
  3. 3Department of Surgery, Baylor Health Care System, Dallas, Texas, USA
  4. 4Department of Surgery, Charles E Schmidt College of Medicine, Florida Atlantic University, Boca Raton, Florida, USA
  5. 5Surgery, University of Florida College of Medicine - Jacksonville, Jacksonville, Florida, USA
  1. Correspondence to Dr Marie Crandall, Surgery, University of Florida College of Medicine - Jacksonville, Jacksonville FL 32209-6511, USA; marie.crandall{at}


More than three million patients every year develop emergency general surgical (EGS) conditions and this number is rising. EGS diseases range from straightforward to potentially life-threatening, and if severe or complex may require extensive resources. Given the looming surgeon shortage and concerns about access to care, regionalization of EGS care, in a manner similar to trauma care, has been proposed. We present a unique pro–con debate highlighting the salient arguments for and against regionalization of EGS care in the USA.

  • emergency general surgery
  • regional
  • resource allocation

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  • Presented at These arguments were presented as a Lunch Session for the American Association for the Surgery of Trauma annual meeting, September 2018, San Diego, California. The original recording can be accessed here.

  • Contributors MC conceived of the work and edited the article. HS, LSK, SS, and LL presented their arguments at the lunch session and drafted their written arguments for the journal. HS assembled and edited the work.

  • Funding HS' effort is supported by a grant from the Agency for Healthcare Research and Quality (R01HS022694). The content represents the thoughts and opinions of the authors and not the funding agencies.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Provenance and peer review Commissioned; externally peer reviewed.

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