It Takes a Team to be Great: Developing a Colorectal Surgery Program with Purpose

Colorectal surgery requires a level of coordination that no single surgeon can achieve in isolation. Diseases such as colorectal cancer, inflammatory bowel disease, pelvic floor dysfunction, among others, demand vertically integrated programs that also function as horizontal connectors across oncology, gastroenterology, women's health, radiology, and pathology. At AdventHealth, the colorectal surgery program has evolved into a natural hub for this type of care. This chapter describes the framework that sustains such a program. Core principles include a shared vision, clear roles, effective leadership behaviors, and structured communication. Education is the cultural foundation, embedding a growth mindset and continuous improvement through fellowship training, simulation, cadaveric courses, and faculty development. Administrative alignment, research integration, and transparent governance ensure that the program remains coherent and accountable. Compensation follows a framework coined CARTS, which balances clinical activity with administrative, research, teaching, and strategic contributions. Industry partnerships, philanthropy, and community engagement extend the program's reach beyond the hospital. The experience demonstrates that high-performing surgical programs are not accidental. They are built through deliberate design, transparent structures, and a culture that views education and collaboration as essential to excellence.