Perspectives, Experiences, and Opportunities of Academic Surgeons in the Era of Health Care Corporatization.

Abstract

To characterize contemporary surgeons' viewpoints and perspectives on the academic mission during health care corporatization. Academic surgery, traditionally driven by the tripartite missions of excellence in clinical care, scientific research, and education, faces increasing challenges from a corporatized health care environment. While previous studies have addressed the financial aspects of corporatization, a comprehensive evaluation of academic surgeons' attitudes and experiences remains lacking. An online survey was distributed to a national sample of academic surgical department chairs and program directors assessing their views, perspectives, and experiences with health care corporatization. We also analyzed trends in National Institutes of Health funding and abstract submissions to the Academic Surgical Congress. Of 105 respondents, 72.9% believe corporatization negatively impacts academic surgery. Among program directors, 79.1% feel corporatization emphasizes clinical productivity over research and teaching. Similarly, 82.8% of department chairs report their faculty often must prioritize clinical duties over other academic responsibilities.Qualitative analysis reveals that surgeons perceive corporatization as a significant barrier to achieving their goals. Many feel that profit has become "king," reducing their roles to "cogs in a wheel."While overall National Institutes of Health funding increased, the proportion awarded to surgical departments remained largely unchanged from 2006 to 2023 (2.7% vs 2.8%, P = 0.94). In addition, the proportion of basic science abstracts submitted to the Academic Surgical Congress declined by 37.9%. Corporatization has had a profound impact on surgeons' perceptions of their roles, responsibilities, and autonomy. Surgical departments must take intentional steps to preserve the multidimensional mission of the academic surgeon.