I don’t know how many times I’ve heard…”just a general surgeon.” It doesn’t really bother me, but, I do have the general impression that there are those that automatically discount a small rural hospital due to the mistaken perception that bigger is better, as though all those doctors at all those smaller hospitals don’t have the experience or knowledge of the big city doctors. The fact is that all those small town doctors actually trained in the big cities and major universities, and they are in the small communities by choice rather than necessity. Although, historically, there may have been a regional standard, it is the case, and has been for many years, that there exists a national standard.