Scholars@Duke
Michelle Richardson Brownstein

Michelle Richardson Brownstein

Associate Professor of Surgery
Trauma, Acute, and Critical Care Surgery
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Selected Publications

Cues to care: Chronic disease diagnosis in young adult trauma patients.

Conference J Trauma Acute Care Surg · January 1, 2024 BACKGROUND: Prevention of chronic disease necessitates early diagnosis and intervention. In young adults, a trauma admission may be an early contact with the health care system, representing an opportunity for screening and intervention. This study estimat ... Full text Link to item Cite

Trends in Surgeon Burnout in the US and Canada: Systematic Review and Meta-Regression Analysis.

Journal Article J Am Coll Surg · January 1, 2023 BACKGROUND: Burnout among surgeons is increasingly recognized as a crisis. However, little is known about changes in burnout prevalence over time. We evaluated temporal trends in burnout among surgeons and surgical trainees of all specialties in the US and ... Full text Link to item Cite

Practice Characteristics and Job Satisfaction of Private Practice and Academic Surgeons.

Journal Article JAMA Surg · March 1, 2021 IMPORTANCE: Private practice and academic surgery careers vary significantly in their daily routine, compensation schemes, and definition of productivity. Data are needed regarding the practice characteristics and job satisfaction of these career paths for ... Full text Link to item Cite

Development and Assessment of a Systematic Approach for Detecting Disparities in Surgical Access.

Journal Article JAMA Surg · March 1, 2021 IMPORTANCE: Although optimal access is accepted as the key to quality care, an accepted methodology to ascertain potential disparities in surgical access has not been defined. OBJECTIVE: To develop a systematic approach to detect surgical access disparitie ... Full text Link to item Cite

Navigating the Infinite Number of Educational Resources: The Development of a Publicly Available Surgical Educational Digital Resource Library.

Journal Article J Surg Educ · 2021 OBJECTIVE: There has been an explosion of digital resources available for general surgical education and board preparation. This makes it difficult for a new learner, regardless of their training level, to determine which resources best fit their needs. Th ... Full text Link to item Cite

Systemic Response to Trauma

Chapter · January 1, 2021 The body activates multiple systems in response to trauma. These reactions are complex and initiated to protect the body, but sustained reactions can be harmful. The goals of treatment are directed at minimizing the magnitude of injury and preventing furth ... Full text Cite

Hypertension in the Young Adult Trauma Population: Rethinking the Traditional "Incidentaloma".

Journal Article J Surg Res · December 2020 BACKGROUND: Hypertension (HTN) is a treatable and preventable risk factor for cardiovascular disease that is often overlooked in young adults. As a result, young patients with HTN may enter the health care system as a trauma without a preexisting diagnosis ... Full text Link to item Cite

Associations Between Career Satisfaction, Personal Life Factors, and Work-Life Integration Practices Among US Surgeons by Gender.

Journal Article JAMA Surg · August 1, 2020 IMPORTANCE: Burnout among US surgeons is alarmingly high, particularly among women, and work-life integration conflicts contribute to career dissatisfaction. OBJECTIVE: To evaluate associations between surgical career satisfaction and personal life factors ... Full text Link to item Cite

Survey of the US Surgeon Workforce: Practice Characteristics, Job Satisfaction, and Reasons for Leaving Surgery.

Conference J Am Coll Surg · March 2020 BACKGROUND: An impending surgeon shortage looms in the US due to increasing demand and a stagnant number of surgeons entering practice. We sought to evaluate the state of our surgical workforce by exploring current practice patterns, job satisfaction, and ... Full text Link to item Cite

Risks and Realities of Delayed Splenic Bleeding.

Journal Article Am Surg · August 1, 2019 Delayed splenic bleeding (DSB) is a poorly understood complication of blunt splenic injury. Treatment for splenic bleeding may involve splenectomy, but angioembolization is becoming a widely used adjuvant for management. Using the North Carolina Trauma Reg ... Link to item Cite

Blunt small bowel perforation (SBP): An Eastern Association for the Surgery of Trauma multicenter update 15 years later.

Journal Article J Trauma Acute Care Surg · April 2019 BACKGROUND: Previous work demonstrated diagnostic delays in blunt small bowel perforation (SBP) with increased mortality and inability of scans to reliably exclude the diagnosis. We conducted a follow-up multicenter study to determine if these challenges p ... Full text Link to item Cite

Variation of surgery clerkship grades in US medical schools.

Journal Article Am J Surg · February 2019 BACKGROUND: Despite efforts at standardization, evaluation and reporting of clerkships remains highly variable. This study reviews the current spectrum of surgical clerkship grading. METHODS: Data were reviewed for every medical school from which an applic ... Full text Link to item Cite

A 2e Parent’s Journey Persistence, Partnership, and the Provision of Unconditional Love

Journal Article Gifted Child Today · October 1, 2015 I have four children, three of whom are twice exceptional in the context of the new Community of Practice (2e CoP) definition highlighted in this issue. I share a personal story of a parent’s journey in persistence, partnerships, and the provision of uncon ... Full text Cite

Women in Academic General Surgery

Journal Article Academic Medicine · January 1, 2004 Purpose. To portray the professional experiences of men and women in academic general surgery with specific attention to factors associated with differing academic productivity and with leaving academia. Method. A 131-question survey was mailed to all fema ... Full text Cite

Comparison of private versus academic practice for general surgeons: a guide for medical students and residents.

Journal Article J Am Coll Surg · December 2003 BACKGROUND: Medical students and residents often make specialty and practice choices with limited exposure to aspects of professional and personal life in general surgery. The purpose of this study was to portray practice composition, career choices, profe ... Full text Link to item Cite

Alteration in Kupffer cell function after mild hemorrhagic shock.

Journal Article Shock · May 2001 Functional changes in Kupffer cells occur after profound hemorrhagic shock. This study was performed to demonstrate if Kupffer cell changes also occur after mild hemorrhagic shock. Sprague-Dawley rats were bled to a systolic blood pressure of 60 to 70 mmHg ... Full text Link to item Cite

Cues to care: Chronic disease diagnosis in young adult trauma patients.

Conference J Trauma Acute Care Surg · January 1, 2024 BACKGROUND: Prevention of chronic disease necessitates early diagnosis and intervention. In young adults, a trauma admission may be an early contact with the health care system, representing an opportunity for screening and intervention. This study estimat ... Full text Link to item Cite

Trends in Surgeon Burnout in the US and Canada: Systematic Review and Meta-Regression Analysis.

Journal Article J Am Coll Surg · January 1, 2023 BACKGROUND: Burnout among surgeons is increasingly recognized as a crisis. However, little is known about changes in burnout prevalence over time. We evaluated temporal trends in burnout among surgeons and surgical trainees of all specialties in the US and ... Full text Link to item Cite

Practice Characteristics and Job Satisfaction of Private Practice and Academic Surgeons.

Journal Article JAMA Surg · March 1, 2021 IMPORTANCE: Private practice and academic surgery careers vary significantly in their daily routine, compensation schemes, and definition of productivity. Data are needed regarding the practice characteristics and job satisfaction of these career paths for ... Full text Link to item Cite

Development and Assessment of a Systematic Approach for Detecting Disparities in Surgical Access.

Journal Article JAMA Surg · March 1, 2021 IMPORTANCE: Although optimal access is accepted as the key to quality care, an accepted methodology to ascertain potential disparities in surgical access has not been defined. OBJECTIVE: To develop a systematic approach to detect surgical access disparitie ... Full text Link to item Cite

Navigating the Infinite Number of Educational Resources: The Development of a Publicly Available Surgical Educational Digital Resource Library.

Journal Article J Surg Educ · 2021 OBJECTIVE: There has been an explosion of digital resources available for general surgical education and board preparation. This makes it difficult for a new learner, regardless of their training level, to determine which resources best fit their needs. Th ... Full text Link to item Cite

Systemic Response to Trauma

Chapter · January 1, 2021 The body activates multiple systems in response to trauma. These reactions are complex and initiated to protect the body, but sustained reactions can be harmful. The goals of treatment are directed at minimizing the magnitude of injury and preventing furth ... Full text Cite

Hypertension in the Young Adult Trauma Population: Rethinking the Traditional "Incidentaloma".

Journal Article J Surg Res · December 2020 BACKGROUND: Hypertension (HTN) is a treatable and preventable risk factor for cardiovascular disease that is often overlooked in young adults. As a result, young patients with HTN may enter the health care system as a trauma without a preexisting diagnosis ... Full text Link to item Cite

Associations Between Career Satisfaction, Personal Life Factors, and Work-Life Integration Practices Among US Surgeons by Gender.

Journal Article JAMA Surg · August 1, 2020 IMPORTANCE: Burnout among US surgeons is alarmingly high, particularly among women, and work-life integration conflicts contribute to career dissatisfaction. OBJECTIVE: To evaluate associations between surgical career satisfaction and personal life factors ... Full text Link to item Cite

Survey of the US Surgeon Workforce: Practice Characteristics, Job Satisfaction, and Reasons for Leaving Surgery.

Conference J Am Coll Surg · March 2020 BACKGROUND: An impending surgeon shortage looms in the US due to increasing demand and a stagnant number of surgeons entering practice. We sought to evaluate the state of our surgical workforce by exploring current practice patterns, job satisfaction, and ... Full text Link to item Cite

Risks and Realities of Delayed Splenic Bleeding.

Journal Article Am Surg · August 1, 2019 Delayed splenic bleeding (DSB) is a poorly understood complication of blunt splenic injury. Treatment for splenic bleeding may involve splenectomy, but angioembolization is becoming a widely used adjuvant for management. Using the North Carolina Trauma Reg ... Link to item Cite

Blunt small bowel perforation (SBP): An Eastern Association for the Surgery of Trauma multicenter update 15 years later.

Journal Article J Trauma Acute Care Surg · April 2019 BACKGROUND: Previous work demonstrated diagnostic delays in blunt small bowel perforation (SBP) with increased mortality and inability of scans to reliably exclude the diagnosis. We conducted a follow-up multicenter study to determine if these challenges p ... Full text Link to item Cite

Variation of surgery clerkship grades in US medical schools.

Journal Article Am J Surg · February 2019 BACKGROUND: Despite efforts at standardization, evaluation and reporting of clerkships remains highly variable. This study reviews the current spectrum of surgical clerkship grading. METHODS: Data were reviewed for every medical school from which an applic ... Full text Link to item Cite

A 2e Parent’s Journey Persistence, Partnership, and the Provision of Unconditional Love

Journal Article Gifted Child Today · October 1, 2015 I have four children, three of whom are twice exceptional in the context of the new Community of Practice (2e CoP) definition highlighted in this issue. I share a personal story of a parent’s journey in persistence, partnerships, and the provision of uncon ... Full text Cite

Women in Academic General Surgery

Journal Article Academic Medicine · January 1, 2004 Purpose. To portray the professional experiences of men and women in academic general surgery with specific attention to factors associated with differing academic productivity and with leaving academia. Method. A 131-question survey was mailed to all fema ... Full text Cite

Comparison of private versus academic practice for general surgeons: a guide for medical students and residents.

Journal Article J Am Coll Surg · December 2003 BACKGROUND: Medical students and residents often make specialty and practice choices with limited exposure to aspects of professional and personal life in general surgery. The purpose of this study was to portray practice composition, career choices, profe ... Full text Link to item Cite

Alteration in Kupffer cell function after mild hemorrhagic shock.

Journal Article Shock · May 2001 Functional changes in Kupffer cells occur after profound hemorrhagic shock. This study was performed to demonstrate if Kupffer cell changes also occur after mild hemorrhagic shock. Sprague-Dawley rats were bled to a systolic blood pressure of 60 to 70 mmHg ... Full text Link to item Cite

Relatively short diagnostic delays (<8 hours) produce morbidity and mortality in blunt small bowel injury: an analysis of time to operative intervention in 198 patients from a multicenter experience.

Conference J Trauma · March 2000 OBJECTIVE: Blunt small bowel injury (SBI) is uncommon, and its timely diagnosis may be difficult. The impact of operative delays on morbidity and mortality has been unclear. The purpose of this study was to determine the relationship of diagnostic delays t ... Full text Link to item Cite

Diagnosis and management of blunt small bowel injury: a survey of the membership of the American Association for the Surgery of Trauma.

Conference J Trauma · March 2000 BACKGROUND: Blunt small bowel injury (SBI) may be difficult to diagnose accurately. Diagnostic delays are associated with increased morbidity and mortality. METHODS: A cross-sectional survey of members of the American Association for the Surgery of Trauma ... Full text Link to item Cite

Bovine hemoglobin-based oxygen carrier (HBOC-201) for resuscitation of uncontrolled, exsanguinating liver injury in swine. Carolina Resuscitation Research Group.

Journal Article Shock · February 2000 In the setting of rapidly exsanguinating hemorrhage, resuscitation with intravenous (i.v.) crystalloid solution may not sustain survival before availability of allogenic blood transfusion and surgery. This study tested the hypothesis that bovine hemoglobin ... Full text Link to item Cite

Prospective randomized trial of early initiation and hospital discharge on a liquid diet following elective intestinal surgery.

Journal Article J Gastrointest Surg · 2000 Length of hospital stay after elective intestinal surgery may be related to patient tolerance of a diet. We hypothesized that early initiation and discharge home on a clear liquid diet would decrease the length of hospital stay without increasing morbidity ... Full text Link to item Cite

The effector component of the cytotoxic T-lymphocyte response has a biphasic pattern after burn injury.

Journal Article J Surg Res · December 1998 INTRODUCTION: Burn injury delays allograft rejection and impairs the host defense against infection. These functions are mediated via the cytotoxic T-lymphocyte (CTL) response. The CTL response is divided into antigen recognition/processing and effector ph ... Full text Link to item Cite

Characteristics of women surgeons in the United States.

Journal Article Am J Surg · September 1998 BACKGROUND: Women surgeons are becoming increasingly prevalent. Despite this, there have been few studies of personal or professional characteristics of US surgeons of either gender. METHODS: Data were taken from the Women Physicians' Health Study, a natio ... Full text Link to item Cite

Host priming, not target antigen type, decides rejection rate in mice primed with MHC II "knockout" cultured keratinocytes.

Conference J Surg Res · April 1998 BACKGROUND: Lack of skin for autograft continues to be problematic in patients with large burns. Allograft and xenograft have been used, but are prone to rapid rejection. Use of cultured keratinocytes (CK) and major histocompatibility complex (MHC) II "kno ... Full text Link to item Cite