Academia: Does it infer arrogance from the ivory tower?

Academia is simply how a university community is identified. Academic physicians of all stripes (surgeons, internists, etc.) are employees of medical schools and its parent university. They constitute the faculty. These these physicians have clinical practices and care for patients as well as teach students and residents. Most also have academic interests including basic research in laboratories or clinical investigations with patients. As well there are efforts to translate the basic research findings into clinical practice to improve surgical care of patients.

I am constantly surprised to encounter the belief that academic surgeons (I’ll focus on surgeons) aren’t “real doctors.” My experience is that these surgeons not only perform the gamut of common operations. They also are most likely to be the surgeons performing the most complex operations on the most challenging patients. They are sought out directly by the patients themselves or referred from the private sector. These are patients with advanced cancers and those needing second or third operations where internal scarring adds several degrees of difficulty. I am not questioning competence. It’s a question of interest and willingness to take these patients on. Their operations are challenging and their postoperative course can be lengthy and time consuming.

Academic surgeons practice almost exclusively in university, county/city, and VA hospitals. The first two are usually located in the inner city. Many patients are uninsured (the ACA has helped reduce this number} and have not been receiving routine medical care. Cancers have a chance to progress and medical conditions are untreated. Even Medicaid coverage is insufficient to appropriately reimburse physicians or hospitals. It’s no wonder the private sector is happy to have academia assume care for these patients.