In 2003, fresh from Residency at Loyola in Chicago, I accepted a position with one partner in a rural hospital, Pekin, only 10 miles away from 3 much larger hospitals in Peoria.  This was a fairly heavy acute-care position with ample opportunities to intervene for perforated ulcers and colons along with the usual appendicitis and cholecystitis.  Despite covering a wide breadth of general surgery including vascular and thoracic and endocrine surgery by my partner, no breast care was being offered.  I helped establish a breast care program including sentinel node biopsy, stereotactic biopsy, etc.  Had to personally negotiate a price for a radioactive probe, encourage representatives to bring one for sampling for cases from 2.5 hours away in Chicago, make sure radioactive dye available, etc.  Encouraged/begged plastic surgeons to obtain privileges so immediate reconstruction could be offered.  Initiated and led a tumor board for several years with oncologist, radiation oncologist, radiologist, and pathologist.

Also a dearth of dermatology presence therefore learned a great deal on management of skin cancers and pre-cancerous lesions and developed a strong patient base in our increasingly elderly population.

Since then the financial climate locally has changed dramatically and had to transition after 20 years to a more remote critical access hospital with no gastroenterologists.  Retooling to do upper and lower endoscopy and investigating how else to bring any other needed services to the area.   There is access to a robot so hoping to gain that training as well.

In general, I may be able to shed light on how to survey needs in your environment, and retool to not only keep up to date, but to meet those needs.

• Acute Care
• Professionalism
• Career Development
• Diversity/Inclusion
• Wellness
• Education
• Other

How to navigate being the "unexpected" surgeon, intimidating name, gender, physical habitus, youthful appearance, attractiveness

one-nani_6.doc