Seminars in Colon and Rectal Surgery最新文献

Introduction

Colorectal cancer (CRC) is the third leading cause of cancer deaths for men and women separately and the second leading cause of cancer deaths for men and women combined. CRC screening allows for cancer prevention, early treatment, or cure. Thus, screening can decrease the incidence and mortality of CRC. This supports the importance of making efforts to improve screening rates through public health programs and policy.

Programs and Policy

Government sponsored public health programs have been shown to be effective at increasing CRC screening rates at comparable costs across multiple regions and populations in the United States. Additionally, policy has been evolving to provide more comprehensive coverage of CRC screening tests.

Conclusion

Both public health programming and policy are important tools to increase CRC screening rates, with the ultimate goals of decreasing CRC incidence and mortality. CRC screening and its dissemination has been shown to be adoptable and cost effective, and should continue to be the focus of public health programming and policy efforts.

Advanced practice providers (APPs) have become an integral part of surgical practice over the past 50 years. Understanding the clinical roles of Physician Assistants (PAs) and Nurse Practitioners (NPs) provides insight into practice norms, collaborative opportunities, the nuances of APP independent practice trends, billing practices, and current practice challenges.

Exploring the history, education, and current practice environment of APPs allows a sophisticated understanding of their roles in the inpatient/facility and outpatient/office settings. This article explores the impact of APPs on access to care, and their role across the overall healthcare landscape in the United States particularly as government and healthcare continue to intersect.

The aim of this work is to provide the reader with a nuanced understanding of the factors influencing the current practice of APPs working in surgical fields in the United States and to foster an authentic appreciation of the existing complexities of APPs practicing in the field of surgery in the context of the current evolving national healthcare landscape.

Despite decades of work on advancing outcomes in colon and rectal surgery, social determinants of health (SDOH) remain an unaddressed component in understanding these outcomes to ensure health equity. Consequently, there is evidence that SDOH have a negative impact on morbidity and mortality of those individuals with colorectal cancer and inflammatory bowel disease in comparison to their counterparts. We sought to elucidate the interplay between SDOH with the access and utilization of Medicaid and how best to improve patient care and outcomes through policy changes. Further education how to address SDOH is needed, as well as a continued push for policy makers to create legislation to improve these rampant inequities in medicine.

Advocacy is a key component to a physician's practice; we advocate on behalf of our patients daily. As important as those efforts are, it is equally important that physicians are engaged in health care policy and advocacy on the state and federal level, where decisions are made that can directly impact a physician's ability to care for patients. This article summarizes the importance of physician engagement in these activities, looking at both the legislative and regulatory processes. It reviews how both interact with one another, and the impact it has on the patient-physician relationship. Finally, this article reviews ways in which physicians can easily get involved with advocacy, including providing resources available to assist those who never participated in these efforts before.