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A Q&A with James 'Butch' Rosser, Sunday's ATA 2012 keynote speaker

The Opening Plenary for ATA 2012, which takes place from 3:30-5 p.m. Sunday in the San Jose Civic Auditorium (across the street from the convention center), will include the Kenneth Bird Distinguished Lecture. This year's speaker is James "Butch" Rosser, MD, FACS, a professor of surgery at the Morehouse School of Medicine in Atlanta. A scientist, inventor, futurist, actor, playwright, comic book collector, video gamer and self-proclaimed "terminal 12-year-old," he has given hundreds of lectures, written many articles and books and received many awards.

Rosser recently answered a few questions put forth by ATA 2012 Show Daily editors:

You're a professor of surgery and recent president of the Society of Laparoendoscopic Surgeons – how does telemedicine fit into that particular healthcare arena? How will telemedicine play a part in shaping the future of surgery?
Because of the tremendous advantages of minimally invasive surgery (surgery that uses miniature cameras and televisions with long thin instruments and smaller incisions to produce less pain and get patients back to work earlier) it is of upmost importance that it becomes accessible to a large part of the population. For a nation it is important because the widespread practice of advanced procedures will positively impact workforce readiness and productivity, which are major players in a healthy economy. Some procedures, like gallbladder removal, are very commonplace. But unfortunately, the more advanced procedures have a 17 percent adoption rate. Because patients will be needlessly exposed to large incisions with all of their shortcomings, this low adoption rate cannot be tolerated.
 
Telementoring is the remote guidance of a surgeon with little or no experience with a procedure using telecommunication technology. It is considered an extreme telemedical application (ETA). We must dedicate ourselves to support the community of surgeons with this telemedicine application so that "No Surgeon Enters The Operation Room Alone." With this type of tactical support, innovative training pedagogy, supportive informatics and cutting edge cost-effective technology the modern day miracle of minimally invasive surgery can be available for all. This will change the landscape of surgery forever.

Telemedicine has long been portrayed as a means of connecting the patient to the primary care doctor. Turning that definition around, how can a doctor use telemedicine to improve his/her practice?
In view of coming healthcare reform, the most important concern for all physicians will be excellent patient outcomes. In the future, compensation will be based on the physician's quality of care metric profile. The use of telemedicine will promote a collaborative intimacy between provider and patient that will encourage preemptive surveillance and stable follow-up. This can transform our current "sickcare" system into a true healthcare platform that features disease prevention, cost effectiveness and availability to all.

How can the hospitals of the future use telemedicine to redefine its role in healthcare?
Telemedicine can assist hospital systems to take care of more patients for less with superior outcomes and profitability. Any hospital that incorporates telemedicine into its service provision signature will be positioned to thrive in the future. It may give managed care models an innovative upgrade because of the requirement to effectively take care of a population of patients on a defined reservoir of funds.
 
With "patient-centered healthcare" being a hot topic of discussion these days, how can the patient make the best use of telemedicine?
The best use of telemedicine for the patient will be manifest by the adoption of the Rosser Doctrine of 21st Healthcare. Introduced in 2000 and 2001 during two consecutive World Bank special sessions on the subject, the Rosser Doctrine has three major principles: 1) The expansion of the healthcare workforce with patient-centered care giving empowerment using innovative training and education techniques that make complex concepts and procedures simple; 2) The introduction and dissemination of mobile, cost-effective diagnostic and monitoring technology simple enough for patients and physicians to use; and 3) Telemedicine will provide the command and control cross links between the patient and physician that will help to ensure quality of the expanded patient-centered workforce.

You've been described as an advocate of video games – from a telemedicine perspective. Do video games have a place in healthcare? How can they be used, and what might they accomplish?
In my opinion, the scientifically validated collateral learning assets of video games and other pop culture icons will be key if we are to make a reality of "patient-centered healthcare." If properly harnessed, video game and simulation-enhanced education and training programs can speed knowledge and skill transfer of complex concepts and procedures that will "empower ordinary people to help take care of themselves." With the use of pop culture icons such as video games, music and cinema along with simulation, patients can learn while not knowing they are learning because they are having fun. I have termed this type of learning stealth learning. Former Secretary Dr. Rod Paige called stealth learning "the most significant advance in learning in 300 years. My book "Playin' To Win: A Surgeon, Scientist and Parent Explores the Upside of Video Games" goes more into depth about this innovative approach to individual empowerment.

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