General surgery should be defined as that operative discipline in which surgeons take care of and supervise the care of patients with multiple systems injuries, diseases of the gastrointestinal tract and endocrine glands, and hernias. The training of general surgeons is broad enough to include the care of patients in need of endoscopy, intensive care, and support of the circulation and lungs and the capability of helping the subspecialist with general surgical care.
In this brief essay, I will consider several important areas of recent advancement: shorter hospitalizations for surgical patients, ambulatory surgery, lesser operations for breast cancer, the possibility of fewer operations for gallstones, and centralized care of the injured. These important developments will not increase the work load or require a larger number of general surgeons. A recent study1 of the years 1979 to 1984 indicated that the number of general surgical operations increased much less than