LESLY ANN DOSSETT, MD

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This study looked at how a team-based mentorship program helped new faculty members in academic surgery by interviewing 15 participants. It found that mentoring was most effective when it included emotional support, clear communication, and diverse team expertise, helping faculty feel more satisfied and progressing in their careers. This matters because strong mentorship can lead to quicker promotions and better job retention, which benefits both the faculty members and the institutions they work for. Who this helps: This helps early-career faculty members in academic surgery.

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This study looked at older women (aged 70 and above) who had early-stage breast cancer and whether they received radiotherapy after surgery to remove their tumors. Among over 121,000 patients studied from 2012 to 2021, the percentage who skipped radiotherapy dropped from 53.7% to 46.8%, while the use of a less intense method called moderately hypofractionated radiotherapy increased significantly from 16.4% to 32.9%. This is important because finding ways to reduce unnecessary treatment can improve patients' quality of life and potentially reduce healthcare costs. Who this helps: This helps older breast cancer patients and their doctors.

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This study looked at how often patients undergoing low-risk surgeries in Michigan (like gallbladder removal and hernia repairs) were getting routine tests before their procedures. It found that the testing rates dropped from 44% to 39% between 2019 and 2024, but there was still a lot of variation among hospitals, with rates ranging from 13% to 93%. This matters because unnecessary testing can lead to higher healthcare costs and delays for patients; improving how often testing is done can streamline care. Who this helps: This helps patients and doctors by reducing unnecessary testing before low-risk surgeries.

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This study looked at how well surgical trainees in the U.S. understand the Commission on Cancer's (CoC) guidelines for cancer surgeries. Only 30% of trainees knew about these guidelines, while 68% of more advanced trainees (fellows) were familiar with them. This lack of knowledge shows that there needs to be better education on these important standards in training programs, which can help improve the quality of cancer surgery and patient care. Who this helps: This helps surgical trainees and ultimately cancer patients by ensuring surgeries are performed to high standards.

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The Commission on Cancer created six new rules to make cancer surgery more consistent and standardized across hospitals. Inspectors who visit these hospitals to check compliance found that the rules are working well, but success depends on whether hospital leaders support them, departments communicate effectively, and there are enough staff and resources—and whether surgeons are willing to follow them. To make these standards actually stick, hospitals need strong leadership backing them up and need to get surgeons on board, while inspectors should officially take on a mentoring role to help hospitals improve rather than just checking boxes.

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This study focused on reducing unnecessary preoperative tests, like blood tests and heart scans, for patients undergoing low-risk surgeries, which don't really help in preventing issues but waste resources and can harm patients. Researchers found that their approach led to a 16% reduction in unnecessary tests during the intervention period and a 27% reduction afterward. This is important because it shows that better strategies can cut down on wasteful medical practices and improve patient care. Who this helps: Patients undergoing low-risk surgeries and their healthcare providers.

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This study looked at how healthcare providers view strategies for reducing unnecessary preoperative tests in patients who are having low-risk surgeries. Researchers interviewed 18 medical professionals and found that educational meetings were the most effective at getting doctors to adopt these strategies. While the strategies reached many providers, there were still challenges related to how different teams work together, showing that customized approaches are needed to improve care and reduce unnecessary testing. Who this helps: This helps patients undergoing low-risk surgeries and their healthcare providers.

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This study looked at treatment trends for breast cancer patients who had a mastectomy and found that many received more treatments than necessary. From 2012 to 2021, the number of patients undergoing axillary lymph node dissection (ALND) alone dropped from 47.1% to 17.6%, while those getting postmastectomy radiotherapy (PMRT) alone rose from 9.8% to 36.8%. The findings highlight that 21.3% of patients still received both treatments together, suggesting a need for careful assessment to avoid overtreatment. Who this helps: This helps breast cancer patients by promoting more tailored treatment decisions.

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This study looked at a new method using tiny iron particles (superparamagnetic iron oxide nanoparticles or SPIO) to help avoid unnecessary surgeries for patients with noninvasive breast cancer. Out of 77 patients who received SPIO, 27.3% showed more serious cancer after their initial surgery, allowing for further checks to be postponed instead of happening right away, which usually happens for most patients. This is important because it can reduce the number of patients undergoing extra surgery and the side effects that come with it. Who this helps: Patients with noninvasive breast cancer who may avoid unnecessary surgeries.

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This study looked at older women (70 years and up) with early-stage breast cancer to find out who might not need a specific type of surgery called sentinel lymph node biopsy (SLNB). Out of nearly 69,000 patients, only 13.4% had cancer in their lymph nodes, and for women with smaller, low-grade tumors, the risk of cancer spreading to the lymph nodes was very low—less than 8% for some groups. This matters because it helps avoid unnecessary surgeries for patients who are unlikely to benefit from them. Who this helps: This helps older breast cancer patients and their doctors by reducing unnecessary procedures.

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This study focused on how surgeons can improve their leadership skills to effectively navigate the complexities of healthcare systems. The researchers discussed practical strategies that can help surgeons at various points in their careers, whether they are just starting out, in leadership roles, or mentoring others. This is important because as healthcare becomes more complicated, better leadership can lead to improved patient care and outcomes. Who this helps: This helps surgeons and healthcare organizations.

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This study looked at how frequently a specific procedure, called sentinel lymph node biopsy (SLNB), is used among women with breast cancer who have positive lymph nodes after initial treatment with chemotherapy. Researchers found that the number of women receiving only SLNB increased significantly from 14% to 39%, while those undergoing a more extensive procedure decreased from 69% to 27%. However, the success rate of collecting three or more lymph nodes during SLNB didn't change much, staying around 66%, with big differences among hospitals, showing that some facilities do much better than others. Who this helps: This research benefits breast cancer patients by highlighting the need for consistent and effective surgical practices.

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This research studied ways to reduce unnecessary preoperative testing before low-risk surgeries at three different hospitals. The team introduced a program called Right-Sizing Testing and made adjustments based on each hospital's needs, such as changing decision-making tools and improving feedback methods. They found that tailoring these strategies led to nine specific improvements that better matched each hospital's systems, which can help cut costs and streamline surgeries. Who this helps: This helps patients and healthcare providers by making the surgical process more efficient and less costly.

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This study looked at the challenges faced by leaders in academic surgery and explored effective strategies to overcome these issues. It found that leaders frequently rely on perseverance and creative problem-solving to navigate difficulties in their roles. This understanding is important because it helps improve leadership skills within surgical departments, ultimately benefiting patient care. Who this helps: This helps doctors and surgical teams improve their leadership abilities.

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This study focused on reducing unnecessary medical tests before low-risk surgeries, which are often not helpful and can even be harmful to patients. Researchers tested a strategy called Right-Sizing Testing Before Elective Surgery (RITE-Size) in three Michigan hospitals, successfully completing all planned steps and reducing testing rates from 68% to 40%. This is important because it shows hospitals can effectively cut down on unnecessary tests, making surgery safer and more efficient for patients. Who this helps: Patients undergoing low-risk surgeries.

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This study looked at how well hospitals are following a new guideline (Standard 5.8) for lung cancer surgery that requires the sampling of lymph nodes. It found that while 80% compliance is expected, only about 50% of hospitals are meeting this requirement. Key issues included uncertainty about the evidence behind the guideline and technical challenges, but many believed that better teamwork among healthcare professionals and regular feedback could help improve compliance. Who this helps: Patients undergoing lung cancer surgery benefit from improved lymph node evaluation, which can lead to better outcomes.

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Researchers looked at how well hospitals followed new guidelines for checking lymph nodes in lung cancer surgeries. In 2022, 54% of hospitals met the standard, but this dropped to just 232 out of 504 (46%) in 2023 due to stricter requirements. These findings highlight a significant challenge in ensuring that patients receive optimal care, as improving lymph node evaluation can lead to better treatment outcomes. Who this helps: Patients with lung cancer benefit from better lymph node evaluations during surgery.

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This study looked at how well hospitals are performing sentinel lymph node biopsies (SLNB) for melanoma patients. Researchers found that over 48,000 patients were treated across more than 1,100 hospitals, with an average of 2.4 lymph nodes removed and about 18% testing positive for cancer. The results showed that SLNB procedures are consistent across facilities, but there is still room for improvement, particularly in other related surgeries. Who this helps: This benefits melanoma patients and the doctors treating them.

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This study looked at why doctors often order unneeded tests before low-risk surgeries, even though guidelines recommend against them. Researchers interviewed 30 healthcare professionals and found three main reasons for this: shared values that prioritize patient safety, a lack of knowledge about testing recommendations, and poor communication among team members. These findings matter because addressing these issues could reduce unnecessary testing, which can save time and money and help patients avoid unnecessary procedures. Who this helps: Patients and healthcare providers.

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This study looked at how to improve the way surgeons make decisions before surgery by reviewing existing research on interventions aimed at changing their behavior. Out of 1,460 articles found, 17 were included in the review, revealing that many strategies focused on improving communication and addressing knowledge gaps among surgeons. Understanding these approaches is important because it can help reduce unnecessary surgeries and improve patient outcomes. Who this helps: This benefits patients seeking more effective and appropriate surgical care.

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This study looked at how older women with early-stage breast cancer make decisions about their treatment, focusing on women aged 70 and over. Among 51 participants surveyed, 86% had lumpectomies, but 28% still underwent unnecessary sentinel lymph node biopsies and 56% received extra radiation, despite guidelines suggesting they shouldn't. The research highlights that patients prioritize survival and local recurrence prevention in their choices, which suggests that many may continue with unnecessary treatments because they believe these options will benefit them. Who this helps: This helps older women with breast cancer make better-informed decisions about their treatment.

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This study looked at why some doctors prescribe androgen deprivation therapy (ADT) too often for prostate cancer, even when it might not be helpful and could cause side effects like diabetes or osteoporosis. Out of 84 urologists surveyed, about 27% felt that they would not stop prescribing ADT when it wasn’t necessary. Understanding these patterns helps develop strategies to reduce unnecessary treatment and improve cancer care. Who this helps: This benefits patients by reducing their exposure to unnecessary risks from overprescribed treatments.

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This study looked at whether a decision-making tool could help older women with early-stage breast cancer avoid unnecessary treatments like certain biopsies and radiation, which are often not needed. Among 23 women who tried the tool, 84% found it helpful and easy to use. After using it, only 19% chose to have a specific biopsy, which is lower than before the tool was introduced. This is important because it shows that using a simple decision aid can lead to better treatment choices and prevent patients from undergoing unnecessary procedures. Who this helps: This helps older women with early-stage breast cancer and their doctors.

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This study looked at how certain surgical standards set by the American College of Surgeons can affect outcomes for women with breast cancer undergoing specific types of surgery to check their lymph nodes. The research analyzed data from over 1.2 million women and found that while facilities showed different results—like an average of 2.6 lymph nodes removed during sentinel lymph node biopsy (SLNB) and a positivity rate of 12.2%—the improvements in patient outcomes were not consistent across the board. Better understanding and following these standards may help reduce variations in surgical results and improve patient care. Who this helps: This benefits patients with breast cancer and their healthcare providers.

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This study looked at how patients with stage-III melanoma feel about their treatment choices and the recommendations they receive from doctors. It found that 69% of patients were advised to choose active monitoring instead of treatment, and most felt satisfied with their decisions, scoring around 28 out of 30 for satisfaction. However, many patients didn't fully understand their choices, showing a need for better communication between doctors and patients. Who this helps: This helps patients with stage-III melanoma and their healthcare teams.

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This study looked at the reasons why many patients do not go home the same day after having a mastectomy without immediate reconstruction. Researchers found that only 16% of these patients in Michigan were discharged on the day of their surgery, despite evidence showing that same-day discharge is safe and leads to higher patient satisfaction. The main barriers included patients not knowing enough about the procedure, surgeons lacking awareness of the evidence for same-day discharge, and issues with how surgical teams operate. Who this helps: This helps patients undergoing mastectomy and the surgeons who care for them.

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This study looked at ways to help doctors avoid overtreatment in older women (70 and up) with early-stage breast cancer who typically don't need certain procedures like sentinel lymph node biopsy (SLNB) and radiation therapy (RT). Researchers found that after a targeted intervention, which included a geriatric assessment and specific communication tools, doctors were more willing to reconsider these treatments. The doctors involved found the strategies helpful and were motivated to change their practices, although time constraints and disagreements among the medical team presented challenges. Who this helps: This benefits older women with early-stage breast cancer by reducing unnecessary treatments.

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This study looked at how mistreatment of medical students during their training affects their ability to communicate effectively with healthcare teams, which can harm patient care. Out of 290 students surveyed, 26% said that mistreatment they experienced in the past hurt their communication, while 30% feared that future mistreatment would do the same. This matters because good communication is crucial for providing safe and effective patient care. Who this helps: This helps patients and medical students.

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Researchers studied how surgeons and oncologists around the world currently manage phyllodes tumors of the breast, which are unusual tumors that can be benign, borderline, or malignant. They found that while most doctors agree on the importance of removing the tumor with a margin of healthy tissue, there is a lot of disagreement about treatment methods, leading to potential overtreatment of patients. Overall, the study highlights the need for clearer guidelines to improve patient care since there were 419 responses from doctors in 16 countries showing varied practices. Who this helps: This helps patients with phyllodes tumors by aiming for better treatment standards.

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This paper studied how mental shortcuts, known as cognitive biases, affect decisions made during surgeries. The authors found that these biases can lead to mistakes, resulting in serious issues such as delayed surgeries and unnecessary procedures. Addressing these biases is important as it can help improve patient outcomes and reduce medical errors. Who this helps: This helps patients and surgical teams by promoting safer surgical practices.

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This research paper examined the disparities in surgical care faced by racial and ethnic minorities in the U.S. It found that there are effective strategies, identified through various studies, that can reduce these inequities. For instance, by implementing certain patient care methods and policy changes, health systems can improve surgical outcomes for minorities, ultimately aiming for equal access and quality care for all patients in surgery. Who this helps: This helps patients from racial and ethnic minority groups who face disparities in surgical care.

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This study looked at how the COVID-19 pandemic has affected academic surgery, including areas like patient care, research, and education. It found that as vaccination rates increased, there was gradual progress in returning to normal, but many changes have taken place in how surgeons and trainees operate. Understanding these shifts is important because they help guide future practices and improve outcomes for patients and training. Who this helps: This benefits patients, surgeons, and medical trainees.

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This study looked at the representation of racial and ethnic minorities among medical students, general surgery residents, and complex general surgical oncology trainees in the U.S. It found that from 2015 to 2020, the percentage of underrepresented minorities (URMs) decreased at each level of surgical training, with Black and Hispanic trainees being notably underrepresented compared to the general population. This decline matters because it highlights the need for more diverse healthcare providers to improve patient care and help address disparities in cancer treatment outcomes. Who this helps: This research helps patients, particularly those from minority communities, by emphasizing the need for more diverse healthcare professionals.

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This paper looks at the treatment of early-stage breast cancer, where patients often receive more treatment than necessary. It highlights the importance of using value-based decisions to ensure that patients receive the most effective and appropriate care, reducing the risk of overtreatment. By focusing on what truly benefits patients, the study aims to improve treatment outcomes and overall quality of life. Who this helps: This helps patients with early-stage breast cancer.