Rural surgeons managing complex emergencies often face a difficult decision: Can the patient be treated safely in the community, or is transfer to a better-equipped center necessary?
The Panel Session, “Should They Stay or Should They Go? Managing Complex Cases in Rural to Urban Transfers” (PS104), today at 12:45 pm, will examine that question from both sides of the transfer, with practical guidance for managing challenging cases in rural and resource-variable settings and improving coordination between rural and urban surgeons.
One of more than 30 sessions focused on rural surgery at Clinical Congress 2026, the session will be co-moderated by Catherine M. Straub, MD, FACS, and Seung S. Gwon, MD, FACS. Presenters will address surgical techniques that can help rural surgeons manage emergencies locally, as well as strategies for transferring patients when additional resources or expertise are needed.
Dr. Gwon, a general surgeon who practices at El Centro Regional Medical Center in California, said one goal is to help rural surgeons prepare for emergencies that may stretch their resources and skill sets.
“Sometimes the question is, ‘If I take them to the OR, what do I do? And then after I do it, what do I do after that?’” she said. “It's not necessarily that we can't cut away tissue—we all know how to do that part—but what is involved in the logistics of taking care of the entire course of this patient?”
Community and academic surgeons will address a range of surgical emergencies, including post-bariatric complications, catastrophic abdominal wall issues, head trauma management, and necrotizing fasciitis. Presentations will cover strategies for managing cases when transfer is unavailable, as well as innovative approaches to transferring patients when higher-level care is needed.
Dr. Straub, a general surgeon at Confluence Health Hospital in Wenatchee, Washington, will close the session with, “The Future of Transferring Patients,” examining how rural and urban surgeons can better align their expectations and practices.
“Every surgeon out there has their own challenges and their own competencies, and rather than feeling like we're dumping on each other or don't know how to manage certain things, we just need a realization that it is more frequently the limitations of our hospital systems, rather than the limitations of our talents and our expertise,” Dr. Straub said. “How can we work together to keep patients in their communities, while at the same time providing them with the care that they deserve?”
The session also will highlight approaches already being used to improve transfers and continuity of care. Dr. Gwon, for example, collaborates with academic surgeons to bring patients back to her rural hospital after they undergo surgical procedures at urban centers. The co-moderators also plan to engage the audience in discussion so attendees can share strategies that have worked in their own institutions.
“We want it to be a broader discussion across the panel and with the audience about the challenges we all face, and what individuals have done to get around those challenges,” Dr. Straub said. “We are there to learn from each other and to network with each other.”
