James W. Fleshman M.D.

Johnson, B.A., Waddimba, A.C., Ogola, G.O., Fleshman, J.W., Jr. and Preskitt, J.T. (2020). “A systematic review and meta-analysis of surgery delays and survival in breast, lung and colon cancers: Implication for surgical triage during the COVID-19 pandemic.” Am J Surg Dec 8;S0002-9610(20)30793-5. [Epub ahead of print].

Full text of this article.

BACKGROUND: Thousands of cancer surgeries were delayed during the peak of the COVID-19 pandemic. This study examines if surgical delays impact survival for breast, lung and colon cancers. METHODS: PubMed/MEDLINE, EMBASE, Cochrane Library and Web of Science were searched. Articles evaluating the relationship between delays in surgery and overall survival (OS), disease-free survival (DFS) or cancer-specific survival (CSS) were included. RESULTS: Of the 14,422 articles screened, 25 were included in the review and 18 (totaling 2,533,355 patients) were pooled for meta-analyses. Delaying surgery for 12 weeks may decrease OS in breast (HR 1.46, 95%CI 1.28-1.65), lung (HR 1.04, 95%CI 1.02-1.06) and colon (HR 1.24, 95%CI 1.12-1.38) cancers. When breast cancers were analyzed by stage, OS was decreased in stages I (HR 1.27, 95%CI 1.16-1.40) and II (HR 1.13, 95%CI 1.02-1.24) but not in stage III (HR 1.20, 95%CI 0.94-1.53). CONCLUSION: Delaying breast, lung and colon cancer surgeries during the COVID-19 pandemic may decrease survival.

Fleshman, J. (2020). “The Birth of the Board of Colon and Rectal Surgery: Curtice Rosser JD, MD, FACS, FAPS (January 3, 1891 to October 23, 1969) remembered at Baylor University Medical Center, Dallas, Texas.” Dis Colon Rectum Dec 7. [Epub ahead of print].

Full text of this article.

Great leaders carry a vision with them that shapes and defines their life and their career. They believe in what can be and, in so doing, bring the vision into reality. They motivate others and, by their effort and enthusiasm, drive the betterment of the institution or group with which they find themselves associated. Curtice Rosser JD, MD, was such a man. The world of Colon and Rectal Surgery owes Dr Rosser a great deal of gratitude for his vision and his leadership. Baylor University Medical Center, Baylor College of Medicine and Southwestern Medical College (now University of Texas Southwestern Medical School) also benefitted greatly from his presence during the early part of their existence. The American Board of Colon and Rectal Surgery exists directly because Dr Rosser and his colleagues envisioned colorectal surgery as a self-governing and credentialing subspecialty, equivalent to other strong surgical subspecialties, and invested time, energy and political capital to realize their dream. [No abstract; excerpt from article].

Fleshman, J. W. (2020). “How to Develop a Leadership Training Program.” Clin Colon Rectal Surg 33(4): 204-211.

Full text of this article.

Leadership training is an essential component of faculty development and resident training. Characteristics of leaders include growth mindset, curiosity, humility, selflessness, intrinsic motivation, hunger to achieve, insight, collaboration, harmony, introversion and analytical approach (inherited) and emotional intelligence, empathy, flexibility, adaptability, conflict management, resilience, interpersonal skills, and judgment (learned). Training for each of these characteristics will enhance the leadership abilities of the surgical department.

Gentry, L. and J. W. Fleshman (2020). “Leadership and Ethics: Virtue Ethics as a Model for Leadership Development.” Clin Colon Rectal Surg 33(4): 217-220.

Full text of this article.

Leaders are held to the highest of standards in both performance and ethics. The same is true for leaders in medicine. Thus, medical leaders must give attention to ethical development as well as performance development. Virtue ethics provide a way for the leader to develop ethically. Virtue ethics is the oldest form of ethics. Although other ethical approaches focus on external considerations, virtue ethics focuses on the inward development of character. Following the examples of virtuous people and developing habits of virtue are critical with this approach. The cardinal virtues of prudence, courage, temperance, and justice are considered the most important. Specific virtue lists have also been developed for medical practitioners. All of these virtues can contribute to the enhancement of leadership skills. The virtue approach is especially helpful for leaders because it motivates one to excel in whatever endeavor pursued, whether medicine, leadership, relationships, or life.

Lawson, D. and J. W. Fleshman (2020). “Informal Leadership in Health Care.” Clin Colon Rectal Surg 33(4): 225-227.

Full text of this article.

Informal leaders in nursing, medical specialties, and administration positively impact the success of an institution. Developing all members of the team as leader then becomes important, especially in the area of nursing. The result is less need for management and control and more individual self-motivated participation in quality improvement.