Your clinical practice at Mark Twain Medical Center will span the full spectrum of general surgery, offering the procedural variety that drew many surgeons to the specialty in the first place. Unlike metropolitan positions that often funnel surgeons into narrow subspecialty lanes, this role allows you to maintain and expand your skills across multiple domains. You will perform bread-and-butter general surgery cases alongside endoscopic procedures, breast surgery, and acute care interventions.
The current surgical volume speaks to the community's need and the practice's strong reputation. Expect approximately 100 to 120 procedures monthly, broken down as roughly 35 surgical cases and 75 endoscopies. Clinic days are equally productive, with 35 to 40 patient encounters daily. This volume generates meaningful productivity income above the base salary while keeping your skills sharp across the procedural range.
The case mix reflects true general surgery practice rather than the fragmented subspecialty environment common in larger systems. Your operative experience will include:
The hospital supports appropriate patient selection for a critical access facility. Complex cases requiring resources beyond the hospital's scope transfer to regional centers, while the substantial majority of general surgery needs receive excellent care locally.
The call structure operates on a one-week-on, one-week-off rotation, a schedule that provides genuine separation between work and personal time. During your call weeks, the actual burden remains manageable. Data from the current practice shows approximately 1.5 to 1.8 OR call-ins per week on average. You may receive additional calls requiring chart review or CT interpretation from home, but physical responses to the hospital occur less than twice weekly during most call periods.
The call compensation adds meaningfully to total income. A surgeon covering approximately 180 call days annually would generate $270,000 in call pay alone, on top of base salary, quality incentives, and productivity bonuses.
The hospital functions as the surgical hub for the region, with the clinic located steps from the main facility. This proximity means efficient transitions between clinic and OR responsibilities without the windshield time that fragments productivity at multi-campus health systems. When an urgent surgical need arises during clinic hours, you walk down the hallway rather than fighting traffic across town.
The practice philosophy emphasizes sound clinical judgment and appropriate patient selection. Your surgical partner, Dr. James Gonzales, models this approach consistently. He maintains high standards for case selection, transfers appropriately when indicated, and takes on cases confidently when the hospital's capabilities match patient needs. This culture of clinical excellence without cowboy risk-taking creates a safe, sustainable practice environment.
For surgeons accustomed to production pressure that sometimes conflicts with patient safety, this practice offers a refreshing alternative where doing the right thing and doing well financially align naturally.