John Morton

Current Research Interests

Bariatric Surgery
Morbid obesity represents the second leading cause of preventable death in the US, scheduled to surpass tobacco as the leading cause of preventable death due to obesity’s epidemic rate of growth. Despite this clear and present danger to the nation’s health, only bariatric surgery extends hope to the morbidly obese. Laparoscopy, as in previous clinical iterations, has widened the potential pool of patients seeking surgical management of disease. Accompanying this increase in procedures should be a concurrent rise in bariatric research. Morbid obesity represents for me a compelling juncture of my laparoscopic, public health, and outcomes training that I hope to employ in examining the following questions.

Evidence-Based Surgery
The clinical science of surgery has made spectacular gains in the past century and the new century will no doubt see more advances perhaps with the aid of evidence-based medicine. Surgery has been a recent convert to the philosophy of evidence- based medicine. Surgery results have often been in the form of case series or expert opinion, which are ranked lowly in evidence grading. Given market changes and the consumer revolution reaching medicine, the ability to perform physician-oriented research will be limited. The powerful statistical and epidemiological tools that evidence- based medicine employs can help answer questions that may have no other recourse. Surgery, unlike other clinical sciences, does not lend itself to randomization. Patients, particularly in the laparoscopic experience, will demand only one arm of any randomized study. As a result, widespread dissemination of technology may take place prior to any assessment of the technology. Given these circumstances, well-designed observational studies are often the best approach. In addition, population-based studies provide a “real-world” assessment of clinical practices and avoid any study bias by examining the entire population of interest. In this manner, surgeons can provide evidence for their patients, colleagues, and payers. Evidence-based surgery can provide the ability to assess technology, improve quality of care, and maintain patient safety as noted in the below research questions.

Surgical Education
There has been much discussion regarding quality in medicine and reducing medical error. Concern regarding patient safety in teaching hospitals has focused on resident work hours, particularly call nights. A potential for system improvement lies within our surgical educational system. Given impending constraints on resident work hours, it is important to optimize teaching opportunities. Further argument for improvement of our educational system lies in part with recent unfilled surgery match positions. Resident surgeons are changing in their demographics and life experiences requiring a change in century-old Halsteadian techniques and more emphasis on adult learning. This emphasis on adult learning has further import on continued education for more experienced surgeons, critically important in the setting of new technology and emphasis on competence.