{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,4]],"date-time":"2026-04-04T18:53:39Z","timestamp":1775328819294,"version":"3.50.1"},"reference-count":34,"publisher":"Public Library of Science (PLoS)","issue":"12","license":[{"start":{"date-parts":[[2021,12,30]],"date-time":"2021-12-30T00:00:00Z","timestamp":1640822400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:p>Historical context and converging market conditions present a unique opportunity to study the factors contributing to the formalization of foregut, or upper gastrointestinal, surgery as a new subspecialty in United States healthcare. The aim of this study was to examine the justifications of those pursuing the formalization of a foregut subspecialty and to extract lessons for healthcare leaders on the evolving relationships between competing providers. This was a qualitative, cross-sectional study consisting of interviews, secondary survey data, and observation of society meetings between October 2018 and June 2019. Thirty interviews with healthcare professionals were conducted, transcribed, and analyzed for themes using qualitative coding software. Themes were correlated with observational field notes and archival data and compared against established social theories on professions and medical specialization. Analysis revealed that traditionally competing surgeons and gastroenterologists articulate a professional need to qualify foregut surgical expertise based on superior knowledge and outcomes, to define the allocation of certain tasks and procedures, and to foster collaboration across specialties. Converging market conditions precipitate individual and organizational decisions to pursue formal specialization. Participants in the formalization of this subspecialty should consider the history of professional competition and turf wars to achieve meaningful collaboration. Advocacy for multi-specialty societies and organizational movements could be a model for reduced conflict in other specialties as well.<\/jats:p>","DOI":"10.1371\/journal.pone.0262019","type":"journal-article","created":{"date-parts":[[2021,12,30]],"date-time":"2021-12-30T18:23:18Z","timestamp":1640888598000},"page":"e0262019","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":6,"title":["Inter-specialty collaboration in the formalization of a new foregut subspecialty"],"prefix":"10.1371","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0814-2823","authenticated-orcid":true,"given":"Hannah","family":"Vassaur","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8285-9596","authenticated-orcid":true,"given":"Peter","family":"Martelli","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"340","published-online":{"date-parts":[[2021,12,30]]},"reference":[{"issue":"6","key":"pone.0262019.ref001","doi-asserted-by":"crossref","first-page":"871","DOI":"10.1136\/gutjnl-2012-304269","article-title":"Update on the epidemiology of gastro-oesophageal reflux disease: a systematic review","volume":"63","author":"HB El-Serag","year":"2014","journal-title":"Gut"},{"issue":"2","key":"pone.0262019.ref002","doi-asserted-by":"crossref","first-page":"328","DOI":"10.1007\/s10620-009-0927-9","article-title":"GERD-related health care utilization, therapy, and reasons for transfer of GERD patients between primary care providers and gastroenterologists in a US managed care setting","volume":"55","author":"R Halpern","year":"2010","journal-title":"Dig Dis Sci"},{"issue":"5","key":"pone.0262019.ref003","doi-asserted-by":"crossref","first-page":"1179","DOI":"10.1053\/j.gastro.2012.08.002","article-title":"Burden of gastrointestinal disease in the United States: 2012 update","volume":"143","author":"AF Peery","year":"2012","journal-title":"Gastroenterology"},{"issue":"7","key":"pone.0262019.ref004","first-page":"424","article-title":"A review of new surgical and endoscopic therapies for gastroesophageal reflux disease","volume":"12","author":"RA Ganz","year":"2016","journal-title":"Gastroenterol Hepatol"},{"issue":"4","key":"pone.0262019.ref005","doi-asserted-by":"crossref","first-page":"xiii","DOI":"10.1016\/j.thorsurg.2018.08.002","article-title":"Innovations in and around the foregut","volume":"28","author":"BE Louie","year":"2018","journal-title":"Thorac Surg Clin"},{"key":"pone.0262019.ref006","unstructured":"Society of American Gastrointestinal and Endoscopic Surgeons. 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