The Operative Word

In this episode, Thomas K Varghese, Jr, MD, FACS, is joined by Sarah Remer, MD, from Loyola University Medical Center, and Marcia M Russell, MD, from UCLA. They discuss Drs Remer and Russell's recent article, “Hospital Variation in Postoperative Delirium Screening and Outcomes in Older Adult Surgical Patients: A National Analysis of Geriatric and Non-Geriatric Surgery Verification Hospitals,” which found that in a national cohort of adults aged 75 years and older, Geriatric Surgery Verification (GSV) hospitals demonstrated significantly higher postoperative delirium screening rates than non-GSV hospitals. While delirium positivity was similar, higher screening rate was associated with reduced length of stay and prolonged hospitalization among screened patients, supporting standardized, routine screening.   Disclosure Information: All relevant conflicts have been mitigated and Drs Varghese, Remer, and Russell, moderators, have no relevant financial conflicts to disclose.   To earn 0.25 AMA PRA Category 1 Credits™ for this episode of the JACS Operative Word Podcast, click here to register for the course and complete the evaluation. Listeners can earn CME credit for this podcast for up to 2 years after the original air date.   Ko, C. Y., Rosenthal, R., Remer, S. L., Russell, M. M., & Smolkin, C. (2026). Hospital Variation in Postoperative Delirium Screening and Outcomes in Older Adult Surgical Patients: A National Analysis of Geriatric and Non-Geriatric Surgery Verification HospitalsJournal of the American College of Surgeons https://doi.org/10.1097/XCS.0000000000002043   Learn more about the Journal of the American College of Surgeons, a monthly peer-reviewed journal publishing original contributions on all aspects of surgery, including scientific articles, collective reviews, experimental investigations, and more.   #JACSOperativeWord

In this episode, Lillian Erdahl, MD, FACS, is joined by Clifford Ko, MD, FACS, from UCLA. They discuss Dr Ko’s recent article, “Impact of American College of Surgeons Verification Programs: Systematic Review and Meta-Analysis,” a framework-based systematic review and meta-analysis evaluating the association between ACS verification programs and surgical quality. Across diverse programs and outcomes, verification is consistently associated with improvements in safety, effectiveness, efficiency, equity, and patient-centered care.   Disclosure Information: Dr Erdahl, moderator, has no relevant financial conflicts to disclose. Dr Ko, moderator, is an employee of the American College of Surgeons.   Cohen ME, Remer SL, Grieco A, et al. Impact of American College of Surgeons Verification Programs: Systematic Review and Meta-Analysis Journal of the American College of Surgeons. Published online April 30, 2026. doi:10.1097/XCS.0000000000001980   Learn more about the Journal of the American College of Surgeons, a monthly peer-reviewed journal publishing original contributions on all aspects of surgery, including scientific articles, collective reviews, experimental investigations, and more.   #JACSOperativeWord

In this episode, Thomas K Varghese, Jr, MD, FACS, is joined by Erika Rangel, MD, FACS, from Brigham and Women’s Hospital. They discuss Dr Rangel’s recent article, “Flexibility Stigma and the Double Bind of Family Formation in Medical and Surgical Residency,” which found that flexibility stigma in residency discourages pregnant and parenting trainees from using needed work-life accommodations, creating harmful double binds between training expectations and personal well-being. Structural and cultural reforms are essential to support equity, retention, and trainee health.   Disclosure Information: All relevant conflicts have been mitigated and Drs Varghese and Rangel, moderators, have no relevant financial conflicts to disclose.   To earn 0.25 AMA PRA Category 1 Credits™ for this episode of the JACS Operative Word Podcast, click here to register for the course and complete the evaluation. This activity has been designated as Credit to Address Regulatory Mandates in the following categories: Cultural Competency and Behavioral Health. Individuals MUST check with their state or local medical board, hospital, or organization to verify that the content does meet the specific requirements. Listeners can earn CME credit for this podcast for up to 2 years after the original air date.   Rangel EL, Zeineddine J, Lovejoy MC, et al. Flexibility Stigma and the Double Bind of Family Formation in Medical and Surgical Residency Journal of the American College of Surgeons. Published online May 21, 2026. doi:10.1097/XCS.0000000000002046   Learn more about the Journal of the American College of Surgeons, a monthly peer-reviewed journal publishing original contributions on all aspects of surgery, including scientific articles, collective reviews, experimental investigations, and more.   #JACSOperativeWord

In this episode, Lillian Erdahl, MD, FACS, is joined by Morgan Pettigrew, MD, from UT Southwestern. They discuss Dr Pettigrew’s recent article, “Artificial Intelligence Simplification of English and Spanish Surgical Consent Forms: 1-Size Does Not Fit All,” which found that while ChatGPT-4.0 improved the readability of English surgical consent forms, it did not improve readability of Spanish forms. To address this disparity, the authors developed a custom-trained GPT that improved readability of English and Spanish consent forms.   Disclosure Information: All relevant conflicts have been mitigated and Drs Erdahl and Pettigrew, moderators, have no relevant financial conflicts to disclose.   To earn 0.25 AMA PRA Category 1 Credits™ for this episode of the JACS Operative Word Podcast, click here to register for the course and complete the evaluation. Listeners can earn CME credit for this podcast for up to 2 years after the original air date.   Pettigrew, Morgan F MD; Nunez-Rocha, Ricardo E MD; Govindu, Sai R BS; Castillo, Samy MD; Heslin, Ryan T MD; Bain, Andrew P MD; Abreu, Andres A MD; Fatimah, Nafeesah MD; Polanco, Patricio M MD, FACS; Wang, Sam C MD, FACS. Artificial Intelligence Simplification of English and Spanish Surgical Consent Forms: 1-Size Does Not Fit All. Journal of the American College of Surgeons 243(1):p 202-214, July 2026. | DOI: 10.1097/XCS.0000000000001890   Learn more about the Journal of the American College of Surgeons, a monthly peer-reviewed journal publishing original contributions on all aspects of surgery, including scientific articles, collective reviews, experimental investigations, and more.   #JACSOperativeWord

In this episode, Thomas K Varghese, Jr, MD, FACS, is joined by Serena Lofftus, MD, and James Wu, MD, FACS, from UCLA. They discuss Drs Lofftus and Wu’s recent article, “Patient-Based Decision Making for Opioid Prescriptions After Ambulatory Breast Operation: A Randomized Clinical Trial,” which evaluated whether incorporating patient choice into postoperative prescribing decisions could reduce opioid prescribing and consumption after ambulatory breast operation without negatively affecting pain control or quality of life.   Disclosure Information: Drs Varghese, Lofftus, and Wu have no relevant financial conflicts of interest to disclose.   To earn 0.25 AMA PRA Category 1 Credits™ for this episode of the JACS Operative Word Podcast, click here to register for the course and complete the evaluation. Listeners can earn CME credit for this podcast for up to 2 years after the original air date. Of the AMA PRA Category 1 CreditsTM listed above, a maximum of 0.25 hours meet the requirements for Prescribing Opioids/Controlled Substances.* *The content of this activity may meet certain mandates of regulatory bodies. Please note that ACS has not and does not verify the content for such mandates with any regulatory body. Individual physicians are responsible for verifying the content satisfies such requirements. Lofftus, Serena Y MD1,4; Graham, Danielle S MD, PhD1,4; Le, Julie MD, FACS1,2; Zhu, Catherine Y MD1,3; Kaufman, Noy MD4,5; Huy, Tess C MD1,4; Kusske, Amy M MD, FACS1,4; Teshome, Mediget MD, FACS1,4; Baker, Jennifer L MD, FACS1,4; Wu, James X MD, FACS4,6. Patient-Based Decision Making for Opioid Prescriptions After Ambulatory Breast Operation: A Randomized Clinical Trial. Journal of the American College of Surgeons ():10.1097/XCS.0000000000001974, April 13, 2026. | DOI: 10.1097/XCS.0000000000001974   Learn more about the Journal of the American College of Surgeons, a monthly peer-reviewed journal publishing original contributions on all aspects of surgery, including scientific articles, collective reviews, experimental investigations, and more.   #JACSOperativeWord

In this episode, Lillian Erdahl, MD, FACS, is joined by Pringl Miller, MD, FACS, from Physican Just Equity, and Christine Heisler, MD, FACS, from the Mayo Clinic Health System. They discuss Drs Miller and Heisler’s recent article, “Whether and How Surgeons Took Action Against Workplace Microaggression: Survey of American College of Surgeons Members,” in which the authors found that the most frequent perpetrator roles were surgeon colleagues and supervisors. A total of 57.4% of surgeons took action, with informal reporting to a colleague and/or directly confronting the perpetrator being most common actions taken. Surgeons who took action were less likely to choose a career in surgery again.   Disclosure Information: Drs. Erdahl, Miller, and Heisler have no relevant financial conflicts to disclose.   To earn 0.25 AMA PRA Category 1 Credits™ for this episode of the JACS Operative Word Podcast, click here to register for the course and complete the evaluation. Listeners can earn CME credit for this podcast for up to 2 years after the original air date.   Heisler, Christine A MD, MS, FACS; Godecker, Amy L PhD, MS; Verran, Deborah MbChB, MHSM; Sinha, Michael S MD, JD, MPH; Byam, Jerome MD; Miller, Pringl MD, FACS. Whether and How Surgeons Took Action Against Workplace Microaggression: Survey of the American College of Surgeons Members. Journal of the American College of Surgeons 242(2):p 390-400, February 2026. | DOI: 10.1097/XCS.0000000000001648   Related work: Primary Study: Heisler CA, Godecker AL, Verran D, Sinha MS, Byam J, Miller P. Workplace microaggressions: results of a survey of the American College of Surgeons members. Am J Obstet Gynecol. 2024 Aug;231(2):265.e1-265.e8.   Secondary Study: Heisler CA, Godecker AL, Verran D, Sinha MS, Byam J, Miller P. Impact of Workplace Microaggressions on Surgeon Career Status and Trajectory: A Cross-Sectional Survey Study.  Accepted to the Annals of Surgery Open on April 30, 2026.     The secondary study was also presented at ACS Clinical Congress 2024: Heisler CA, Godecker A, Verran D, Sinha MS, Byam J, Miller P. Workplace Microaggressions and the Impact on a Surgeon’s Career Trajectory: Results of a Survey of the American College of Surgeons Members. J Am Coll Surg. October 2024;239(5):S138-139.   Learn more about the Journal of the American College of Surgeons, a monthly peer-reviewed journal publishing original contributions on all aspects of surgery, including scientific articles, collective reviews, experimental investigations, and more.   #JACSOperativeWord

In this episode, Thomas K Varghese, Jr, MD, FACS, is joined by Carrie Chan, MSN, MPH, from the University of California, San Francisco, and Karthik Balakrishnan, MD, FACS, from Stanford Medicine Children’s Health. They discuss their recent article,“Development, Validation, and Comparison of Machine Learning Models for Predicting Pediatric Surgical Site Infections Using the NSQIP-P Database,” which represents the largest study to date on predicting pediatric surgical site infection. The authors developed machine-learning models and ultimately recommend a regularized logistic regression model for clinical integration, balancing performance and feasibility for implementation. Findings support using routine preoperative data for personalized infection prevention and preoperative planning.   Disclosure Information: Ms. Chan and Drs. Varghese and Balakrishnan have no relevant financial conflicts to disclose.   To earn 0.25 AMA PRA Category 1 Credits™ for this episode of the JACS Operative Word Podcast, click here to register for the course and complete the evaluation. Listeners can earn CME credit for this podcast for up to 2 years after the original air date.   Chan, Carrie T MSN, MPH; Pletcher, Mark J MD, MPH; Balakrishnan, Karthik MD, MPH, FACS; Hswen, Yulin ScD, MPH; Scheffler, Aaron PhD, MS. Development, Validation, and Comparison of Machine Learning Models for Predicting Pediatric Surgical Site Infections Using the NSQIP-P Database. Journal of the American College of Surgeons 242(3):p 712-722, March 2026. | DOI: 10.1097/XCS.0000000000001683   Learn more about the Journal of the American College of Surgeons, a monthly peer-reviewed journal publishing original contributions on all aspects of surgery, including scientific articles, collective reviews, experimental investigations, and more.   #JACSOperativeWord

In this episode, Thomas K Varghese, Jr, MD, FACS, is joined by Laurie J Kirstein, MD, FACS, from Memorial Sloan Kettering. They discuss Dr Kirstein’s recent article, “Results of an American College of Surgeons Prospective National Quality Improvement Collaborative to Successfully Overcome Barriers to Cancer Care Across the US,” in which 194 American College of Surgeons (ACS)-accredited cancer programs caring for 99,057 patients participated in a National Quality Improvement Collaborative led by the ACS, “Breaking Barriers,” which reduced radiotherapy non-adherence by over 30% at the patient and hospital levels across multiple program types, census regions, and disease sites.   Disclosure Information: Drs. Varghese and Kirstein have no relevant financial conflicts to disclose.   To earn 0.25 AMA PRA Category 1 Credits™ for this episode of the JACS Operative Word Podcast, click here to register for the course and complete the evaluation. Listeners can earn CME credit for this podcast for up to 2 years after the original air date.   Chan, Kelley MD, MS; Reilly, Eileen MSW; Janczewski, Lauren M MD, MS; Gentry, Sharon MSN, RN; Biggins, Camille MHA; Haffty, Bruce MD; Shelton, Charles MD; Yang, Anthony D MD, MS, FACS; Weigel, Ronald J MD, PhD, MBA, FACS; Kirstein, Laurie J MD, FACS. Results of an American College of Surgeons Prospective National Quality Improvement Collaborative to Successfully Overcome Barriers to Cancer Care Across the US. Journal of the American College of Surgeons 242(1):p 247-256, January 2026. | DOI: 10.1097/XCS.0000000000001637   Learn more about the Journal of the American College of Surgeons, a monthly peer-reviewed journal publishing original contributions on all aspects of surgery, including scientific articles, collective reviews, experimental investigations, and more.   #JACSOperativeWord

In this episode, Lillian Erdahl, MD, FACS, is joined by Jessica Liu, MD, MS, MPH, from the Department of Surgery, Harbor UCLA Medical Center. They discuss Dr Liu’s recent article, “Identifying Diagnostic Gaps and Mitigation Strategies for Older Adult Emergency General Surgery Patients: A Scoping Review,” in which the authors identified the current diagnostic issues, clinical tools, and clinician feedback strategies in the older adult emergency general surgery (EGS) setting. While challenges unique to older adults exist, variability in the use of tools to improve identification of older adult conditions in EGS and gaps in feedback to improve diagnosis remain.   Disclosure Information: Drs. Erdahl and Liu have no relevant financial conflicts to disclose.   To earn 0.25 AMA PRA Category 1 Credits™ for this episode of the JACS Operative Word Podcast, click here to register for the course and complete the evaluation. Listeners can earn CME credit for this podcast for up to 2 years after the original air date.   Liu, Jessica K MD, MS, MPH; Peters, Xane D MD, MS; Remer, Sarah L MD; Beestrum, Molly MLIS; Cooper, Zara MD, FACS, MPH; Russell, Marcia M MD, FACS; Hall, Bruce L MD, FACS, PhD; Ko, Clifford Y MD, FACS, MSHS, MS. Identifying Diagnostic Gaps and Mitigation Strategies for Older Adult Emergency General Surgery Patients: A Scoping Review. Journal of the American College of Surgeons 241(5):p 904-916, November 2025. | DOI: 10.1097/XCS.0000000000001480   Learn more about the Journal of the American College of Surgeons, a monthly peer-reviewed journal publishing original contributions on all aspects of surgery, including scientific articles, collective reviews, experimental investigations, and more.   #JACSOperativeWord   Copyright © 2026 by the American College of Surgeons (ACS). All rights reserved.   The contents of these materials may be cited in academic publications but otherwise may not be reproduced, disseminated, or transmitted in any form by any means without the express written permission of ACS. These materials may not be resold nor used to create revenue-generating content by any entity other than the ACS without the express written permission of the ACS. The contents of these materials are strictly prohibited from being uploaded, shared, or incorporated in any third-party applications, platforms, software, or websites without prior written authorization from the ACS. This restriction explicitly includes, but is not limited to, the integration of ACS content into tools leveraging artificial intelligence (AI), machine learning, large language models, or generative AI technologies and infrastructures. 

In this episode, JACS Editor-in-Chief Tom Varghese, MD, FACS, and Digital Media Editor Lillian Erdahl, MD, FACS, review 6 impactful articles from the past year, highlighting key themes shaping modern surgical practice. Dr Erdahl focuses on the surgeon as a subject, discussing research on moral distress, second-victim syndrome, health policy challenges, and peer surgical coaching. Dr Varghese then explores advances in surgical science, including pragmatic applications of artificial intelligence for risk prediction and operative documentation, as well as comparative evidence on robotic, laparoscopic, and open operation. Together, they emphasize clinically relevant research, thoughtful innovation, and ongoing critical inquiry to support surgeons and improve patient care. Listen to the podcast episodes mentioned at facs.org/operative-word.   Articles discussed: Surgeon Perception and Attitude Toward the Moral Imperative: Institutionally Addressing Second Victim Syndrome in Surgery A Framework for Managing Moral Challenges Related to Health Policy for the Surgeon What About the Coach? Mixed Methods Study Assessing the Experience of Coaches in a Peer Surgical Coaching Program Validation of Artificial Intelligence-Based POTTER Calculator in Emergency General Surgery Patients Undergoing Laparotomy: Prospective, Bi-Institutional Study Enhancing Accuracy of Operative Reports with Automated Artificial Intelligence Analysis of Surgical Video Robotic vs Laparoscopic vs Open Ventral Hernia Repair: Insights from a Network Meta-Analysis of Randomized Clinical Trials   Disclosure Information: Drs. Varghese and Erdahl have have no relevant financial conflicts to disclose.   Learn more about the Journal of the American College of Surgeons, a monthly peer-reviewed journal publishing original contributions on all aspects of surgery, including scientific articles, collective reviews, experimental investigations, and more.   #JACSOperativeWord