Sustainable Surgical Practice: Defining Workplace Standards for the Modern Era

Behind The Knife: The Surgery Podcast

Medicine, Science, Education, Health & Fitness

4.8 • 1.4K Ratings

🗓️ 20 April 2026

⏱️ 52 minutes

🔗️ Recording | iTunes | RSS

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Summary

In response to increasing surgeon burnout, unsustainable clinical demands, and ongoing loss of surgeon autonomy in the setting of employee-based models, the American College of Surgeons is speaking out. In this episode, hosts Dr. Steven Thornton and Dr. Emma Burke sit down with Dr. Douglas Wood, Chair of Surgery at the University of Washington and Dr. Thomas Varghese, Editor-in-Chief of the Journal of the American College of Surgeons, to discuss the new ACS Workplace Standards Framework. The conversation covers how this initiative grew out of discussions around unionization, what domains the framework addresses — from call intensity and OR block access to administrative burden and inpatient census limits — and how specialty-specific guidelines can be developed and implemented at the local level. Dr. Wood and Dr. Varghese also reflect on the culture of "unlimited endurance" that has long defined surgery, why meaningful systems-level change is both necessary and achievable, and how improving workplace sustainability could transform the pipeline of future surgeons for generations to come.

Hosts: Emma Burke and Steven Thornton

Guests: Dr. Douglas Wood & Dr. Thomas Varghese Jr.

Papers Discussed:
1. Wood DE, Wolinsky PR, Dodgion CM, et al. Developing Specialty-Specific Workplace Standards for Surgeons: A Framework to Support Sustainable Surgical Careers. Journal of the American College of Surgeons, 2026. DOI: 10.1097/XCS.0000000000001880 https://pubmed.ncbi.nlm.nih.gov/41773743/

2. Varghese TK Jr. Toward Sustainable Surgical Practice: Defining Workplace Standards for the Modern Era. J Am Coll Surg. 2026 Mar 3. doi: 10.1097/XCS.0000000000001888. Epub ahead of print. PMID: 41773737. https://pubmed.ncbi.nlm.nih.gov/41773737/

***Fellowship Application Link: https://forms.gle/QSUrR2GWHDZ1MmWC6

Transcript

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0:00.0	Behind the Night, The Surgery Podcast, Relevant and Engaging Content to help you dominate the day. We want you want you, yes, you, to join the Behind the Knife team as a surgical education fellow.
0:39.9	We're looking for enterprising surgical residents to take the bull by the horns and build something new and exciting.
0:46.6	Fellows will benefit from ample support from the Behind the Knife team, including the use of our digital education platform, and access to all of our resources like
0:54.8	illustrators, video editing, AI tools, social media, and more. Get your name out there and
1:00.9	build your CV by being part of the number one surgery education platform in the world. We're offering a
1:07.3	two-year fellowship starting July 26 and ending in June 2028.
1:12.4	Only residents beginning their two-year academic development time will be considered.
1:16.9	Check out the show notes for more information, including the application link.
1:20.4	All applications are due on April 20th.
1:23.7	Again, all applications are due by April 20th.
1:30.3	Now, get out there and dominate the day. Hey, BTK listeners, want to feel more confident in the OR?
1:34.3	Check out our surgical instrument flashcards.
1:36.3	With over 300 instruments, these cards are packed with key tips, subtle distinctions,
1:40.3	and insider tricks you usually pick up after years in the OR. Perfect for students,
1:45.2	surgical technologists, or anyone prepping to scrub a case. You can find them in your library on
1:49.8	the Behind the Knife app or at Behind The Knife.org. Test your knowledge, share them with your learners,
1:54.4	and as always, dominate the day. Hey, welcome back to Behind the Knife. I'm Stephen Thornton, one of
2:00.2	the Behind the Knife Surgical Education Fellows. And today I'm joined by my co-host, Dr. Emma Burke. It's really great to be here today, Stephen. This is one of those episodes that I think will hit really close to home for pretty much everyone listening, whether you're a resident grinding through training or in attending a decade into practice wondering how you got here.
2:18.4	That's exactly right. Today we're talking about surgeon well-being and workplace sustainability.
2:24.1	And specifically, two brand new papers out of the Journal of the American College of Surgeons
2:29.0	that I think represent a great example of the advocacy coming out of the college these days.
2:35.1	And we have two incredible guests to walk us through this work. First, we have Dr. Douglas Wood.
	...

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