General surgery with a special interest in vascular surgery: is the tail starting to wag the dog?

Most general surgeons are expected to develop an interest in a surgical specialty in addition to their general surgical workload. Over a 2-year period we have prospectively analysed the type of patient admitted to a general surgical unit with a special interest in vascular surgery. Half of the admissions were emergencies, over which we had no control. Of the elective admissions, there was a steady increase in the proportion of patients with a vascular diagnosis. This was due to increasing numbers of arterial reconstructions and interventional radiological procedures being undertaken. As cutbacks are made in the numbers of available beds and operating sessions, the increasing number of patients requiring admission for the management of arterial disease can only be achieved at the cost of patients awaiting routine general surgical procedures.