In this episode, Tom Varghese, MD, FACS, is joined by Timothy Pawlik, MD, FACS, from The Ohio State University. They discuss Dr Pawlik’s recent article, “Association of Discharge Against Medical Advice with Surgical Outcomes and Healthcare Cost,” in which the authors found that discharge against medical advice (DAMA) among surgical patients is associated with increased 30-day readmission, complication, fragmented care, and higher healthcare cost. DAMA patients were younger, socioeconomically vulnerable, and often had substance use or psychiatric disorders.  

Disclosure Information: Drs Varghese and Pawlik have nothing to disclose. 

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Sarfraz, Azza MBBS; Khalil, Mujtaba MD; Woldesenbet, Selamawit PhD; Altaf, Abdullah MD; Rashid, Zayed MD; Zindani, Shahzaib MD; Kawashima, Jun MD; Pawlik, Timothy M MD, PhD, MPH, MTS, MBA, FACS. Association of Discharge Against Medical Advice with Surgical Outcomes and Healthcare Costs. Journal of the American College of Surgeons 241(5):p 822-832, November 2025. | DOI: 10.1097/XCS.0000000000001469 

Learn more about the Journal of the American College of Surgeons, a monthly peer-reviewed journal publishing original contributions on all aspects of surgery, including scientific articles, collective reviews, experimental investigations, and more. 

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