M. Margaret (Peggy) Knudson, MD, FACS, professor of surgery at the University of California, San Francisco (UCSF), and trauma surgeon at San Francisco General Hospital and Trauma Center, has joined the Division of Member Services of the American College of Surgeons (ACS) as Medical Director of the Military Health System Strategic Partnership American College of Surgeons (MHSSPACS). This three-year partnership was officially launched with the signing of a charter during the ACS Clinical Congress 2014 in San Francisco. The partnership will enable the sharing of training and educational platforms, research endeavors, quality improvement programs, and combat readiness and disaster preparedness efforts. Ultimately, the work of the partnership is intended to benefit surgical patients in both the civilian and combat arena in the U.S. and throughout the world.
For Dr. Knudson, this new responsibility is a natural progression in a career dedicated to trauma care. “These are activities I have been doing all along and this new partnership is really an extension of the Senior Visiting Surgeon exchange program in Landstuhl, Germany, supported by the ACS Committee on Trauma (COT), the American Association for the Surgery of Trauma, and the U.S. military,” she said. “The U.S. war in Iraq has been a training ground for combat casualty care, resulting in the fewest number of deaths ever recorded as a result of wartime wounds.” Many lessons regarding the care of trauma patients have been learned during the 13-year military involvement in Iraq and Afghanistan, the longest war in U.S. history, she said. “This is a very important time in history. What a shame it would be if we couldn’t study the treatment of battlefield injuries in a more controlled setting in the civilian world.
“The military surgeons are really looking for a surgical home for medical students and residents who are training at military facilities, as well as for active duty and reserve surgeons and those who have separated. Much of this effort will be focused around the ACS Clinical Congress,” Dr. Knudson added. The new partnership will provide a mutually beneficial exchange of educational, quality of care, and research efforts between military and civilian surgeons.
Dr. Knudson brings to her new role with the College years of experience serving on the front lines of trauma care. She treated victims of major disasters, including the 2010 earthquake in Haiti, and the crash of Asiana Airlines Flight 214 in San Francisco in July 2013. In 2007, as Vice-Chair of the ACS COT, Dr. Knudson participated in the first Verification Review Committee (VRC) site visit outside the U.S., at Landstuhl Regional Medical Center (LRMC) in Germany. LRMC, a permanent U.S. military installation and the largest American military hospital outside the U.S., was seeking verification as a Level II trauma center. Dr. Knudson and the other VRC members performed a site visit as they would for any other trauma center. They evaluated the medical center’s resources, interviewed hospital personnel, toured the facilities, and reviewed selected medical records and performance improvement materials to determine the quality of care provided. In the end, the reviewers praised the medical center for its high quality of care and encouraged administrators to pursue a Level I verification. In 2011, LRMC became a Level I trauma center.
In 2008, Dr. Knudson traveled with a team of physicians to Iraq’s Balad Air Force Base to share information about operations at their hospitals and how their collective knowledge might improve the delivery of trauma care on the battlefield. The trauma system in Iraq, similar to those established in civilian hospitals, helps ensure that wounded service members have the optimal opportunity to survive and recover from battlefield injuries. Patients are transported to military treatment facilities based upon the level of care that the facility is able to provide. Many patients, service members, and U.S. and Iraqi civilians are transported to the Balad hospital for severe injuries. At the conference, Dr. Knudson raised the issue of the delivery of injured patients and the complications and challenges faced by individuals who fly severely injured patients to care. Conference participants discussed issues regarding resources, adherence to clinical practice guidelines, and the medical evacuation of critically ill or injured patients to another facility with the needed services.
Dr. Knudson eventually served the maximum number of years allowed on the national level of the COT. Although she remains involved in the activities of the COT in both Region 7 and Region 9, she is pleased that her involvement in the partnership will extend her association with the COT nationally. Dr. Knudson served as Chair of the ACS Prevention and Control Committee (2003–2009) and as COT Vice-Chair (2006−2010).
Dr. Knudson is the director and a principal investigator of the San Francisco Injury Center, funded by the Centers for Disease Control and Prevention. She attended medical school and completed her general surgical residency at the University of Michigan in Ann Arbor. After a fellowship in pediatric surgery at Stanford University, she became involved with the development of trauma systems in California, with a special interest in pediatric trauma. She joined the teaching faculty at the UCSF in 1989.
Dr. Knudson and her husband, Stephen A. DeLateur, PhD, live in Los Altos, CA, and have twin daughters who are now young adults.