From Venezuela to PAH: Franco’s practices of respect, creativity prove beneficial

PUNXSUTAWNEY — Gustavo Franco, M.D., Punxsutawney Area Hospital's most recent addition to the position of general surgeon, has traveled a long road to end up in Punxsutawney, but since he took over for former general surgeon Dr. Kaufman, Franco says he's really starting to get the feel for the small-town life.

"So far, everything's been just great," he said in an interview early this week. "I moved here with my wife, Carolina, and my little three-year-old daughter, Carmen, in the beginning of December, and we're still unpacking stuff from the move. But we're getting there. We're learning the area, and we're very pleased with the town, and especially the people."

Professionally, Franco said the transition has been a smooth one, as well.

"Well, to be honest, thanks to Laurie (Klingensmith) and the rest of the staff, I came to know the system quickly," he said. "I'll tell you, though, that it was a thorough orientation period. I met everyone,
and I'm learning all of their names. I feel comfortable with all the areas and different staffs, from the operating room to the other medical staffs. Everyone has been supportive, and I have a very good feeling about how we're going to work together."

The long journey for Franco started in Venezuela, where he was raised, and despite his medical training there, he had to do a bit more training when he reached the States.

"In Venezuela, the program was a six-year program, and I trained as a general surgeon there, which included working two years as a general doctor before three years of schooling for general surgery. But in order to work in the United States, I also had to do my training here."

That means that when Franco came to practice in America, he had to complete another residency program. His thoughts on doing so?

"Since I like general surgery, I didn't mind that so much," he said.

Practicing in Venezuela, though, meant limitations to the procedures and technological advances he could take advantage of, which Franco credits as part of the reason he wanted to practice in the U.S.

"Growing up in Venezuela is quite similar to growing up here," he said. "I grew up there, and I had good training, but the economical limitations made me want to expand my horizons — to come here and get involved with the United States profession. The accessibility is much better here, from resources to technology. Your results come quicker for tests you have done, things like that.
Training and practicing in Venezuela wasn't all that bad for Franco, though, as he said it forced him to learn to think outside the box when it comes to patient treatment.

"I have very good training in problem solving, because you didn't always have the resources," he said. "That training gave me fewer limitations.

If something was missing, I knew I had to make it work with what I had. You learn to pay attention to every single symptom, which is why time with the patient is so important to me. Just listening to the patient may help eliminate a few tests when it comes to making a diagnosis."

One particular area of study his move from Venezuela provided Franco with is the opportunity to expand his passion for laparoscopic procedures, which are procedures that are done using very small incisions and specialized instruments.

"I've always been interested in laparoscopic procedures," he said. "They deal with small cuts, tiny cameras and long, skinny instruments. You can do many of the procedures that used to require open surgery with these long, skinny tools, which I learned about while completing my fellowship (at INOVA Fairfax Hospital in Fairfax, Va.).

Franco's medical training in the States didn't begin at INOVA, though, as he completed his residency at St. Agnes Hospital in Baltimore, Md.
He also spent the past year practicing in the Washington, D.C. area, but cited promising reasons for seeking a smaller hospital.

"My wife and I decided to move to a smaller community where we could spend some more time together as a family while still being able to be a service to the community," he said. "I used to drive 45 minutes to work every day, but that's a tough trip to make each day."

PAH has made clear its desire to serve the patients holistically, and Franco's priorities when it comes to treatment align perfectly with that mission.

"I think that, last year, my opportunity to work in a hospital just a bit smaller than this one (PAH) was an asset," he said. "It was one of my favorite places because you got to know the staff; they know you; and it makes it easier to work as a team. Us working together is key for patient safety and satisfaction."

A large part of building that relationship and trust with the patients, Franco said, is respect.

"I have a policy to respect everybody," he said. "We are a family together in this town, and that's my base with my relationship with the staff, patients and everyone. I respect them, and I expect them to respect me. It has been a great policy so far."

Franco said his desire to become a surgeon is partially driven by that desire to respect and help others, while he also admitted that part of it is the thrill of solving the problems that better those he's serving, as well.

"I think it is two-fold," he said. "I like it from the scientific standpoint. The human being is the most perfect machine ever. There are so many things we don't know about the body. Yet, here we are. I also like to make sure people can go back to their normal lives, though. I like to help keep the community and society running properly. It comes with great satisfaction to help a man who has had a hernia for years and is practically disabled when you see him return to his normal life."

And as a general surgeon, Franco has a broad opportunity to serve a variety of patients with a variety of ailments.

"As surgeons, we are known for doing invasive procedures," he said. "That means we make cuts, or incisions, and work inside the body. The general surgeon's time is broken into surgery time in the operating room and patient time. In the patient time, we get to know the patient and his or her family history, which is important in many cases. If we decide the patient needs intervention — from a scope to an actual open operation — I will also use that time to sit down with the patient and discuss the procedure with him or her."

In the operating room, Franco said every patient is unique, forcing him, at times, to lean on the critical thinking he developed so well in Venezuela.

"Every case, to me, has been different," he said. "When you do these procedures, though, you see a different side of the anatomy. Every surgery is a chance to learn more about the anatomy and the workings of the human body."

The role of the general surgeon is diverse by definition, as well, Franco said.

"We take care of many of the general problems people face, and we work to do so within the protocol set aside for us. But the patient's safety and satisfaction always come first," he said. "After discussion with the patient, we will also see them post-operation to make sure there are no complications, which can come with any surgery, no matter how well it is done. Our knowledge and resources are sufficient, but making sure the patient finds the best way to recover is part of the process."

Another thing he said he is glad to be a part of is PAH's ability to provide emergency surgeries when needed, as living in the community allows him to be on call through the Emergency Department.

"We are always in continual and fast communication with the ER department, and once we confirm the need for surgery, that allows us to provide both the elective and the emergency care to the community."

Through the normal business week, there is someone in Dr. Franco's office Monday through Friday from 8 a.m. to 4 p.m., and he sees patients on Tuesday, Wednesday and Friday, while he spends the other days in the operating room.

Anyone looking for an appointment or individuals with surgical problems can call the office at 938-7045.

In closing, Franco offered thanks to the town of Punxsutawney.

"Thanks so much to the entire community," he said. "So far, everything has been going so well, and I'm very happy to be here."