Seven years ago, Gregory Peck was working as a busy trauma surgeon, often spending more than 100 hours a week keeping people alive in the operating room or the intensive care unit. Then his father, a contractor, died because he wasn't wearing an anchored safety harness while working on a roof.
"I realized at that time that no matter what I could have done even if he was brought into my operating room, I would not have been able to save my father's life. The accident was 100 percent preventable." said Peck. "I needed to find a way to prevent the type of accident that led to my father's death in the first place, rather than waiting to react to the devastating injuries he sustained."
Today, Peck, associate professor of surgery at Rutgers Robert Wood Johnson Medical School, is one of a small number of critical care surgeons in the country funded by the National Institutes of Health researching primary care and prevention over emergency care and surgical intervention.
"There has to be a more effective and efficient way to deal with diseases and injuries that cost billions of dollars," Peck said. "After my father's death, and caring for patient after patient during their life-threatening situation, a switch flipped for me. I knew that I had to try and find a solution that made sense for our future generation."
Growing up in a household with an income below the federal poverty level, and raised by parents who didn't graduate high school or go to college, Peck has always pushed forward. Frequently absent and often in trouble, he didn't graduate from high school on time in 1994. After spending time in an adolescent inpatient disciplinary and substance abuse program, Peck decided to steer himself in a different more productive direction, crack down on his studies and earn his diploma at the end of that year.
Despite not being a model student, and after receiving some preventive care of his own, by college Peck realized that he wanted to be a surgeon. "I was always a risk-taker, but wanted to figure out how to apply that to taking healthier, more responsible risks that could pay off in the long run. I liked to work with my hands from the years of summers working with my father and I wanted to help vulnerable people,'' said Peck, who was a star high school baseball pitcher before suffering an arm injury. He says that turn of events sent him down a short, but destructive, path because he was grieving the loss of a promising collegiate and potentially professional baseball career.
After spending time at community college, Peck graduated from Cornell University in 1999 with a bachelor's degree in biology. Next came Rowan University where he received his Doctor of Medicine in 2006, followed by postgraduate clinical training at Emory University and Grady Memorial Hospital in Atlanta, Georgia.
Board certified in general surgery and surgical critical care, Peck has spent much of his medical career treating patients with acute life-threatening diseases - severely inflamed gallbladders, perforated bowels, strangulated hernias, or gunshot wounds to the chest or abdomen - who came to the hospital for late-stage emergency care to avoid death and disability.
After losing his father, Peck realized that his surgeon's scalpel would not ultimately save those like his father who had little chance of survival.
"I realized that reacting to very late-stage disease all the time or operating on kids being brought into the emergency rooms around the country either from urban violence or suburban mass shootings, must first be examined at the policy level and then be acted on at the community level," said Peck who received a master's degree from the Rutgers School of Public Health in 2020 and is working towards a master's degree in clinical and translational science from the Rutgers School of Graduate Studies.
Peck wants to keep people out of the emergency department by educating patients and the public on the importance of accessing primary care. Public safety measures that could have helped save his father, he says, are like public health policies that stress preventive instead of emergency care.
"The lack of opportunity I have to prevent who and why people were coming to the emergency room made me realize that I needed to take a different approach if I wanted to accomplish equitable health, no matter the color of their skin, their country, or how much money they make," he said.
Peck's current research, funded with a $1 million grant from the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) at the National Institutes of Health, emphasizes this need. Although gallstone disease, the most common digestive disease requiring emergency surgery, has decreased overall in New Jersey, Peck's research indicates that after Medicaid was expanded in 2014 emergency surgery increased for Medicaid recipients, which means more work needs to be done.
"Many people's health worsens because they are not seeking primary care," Peck said. "This sends them to the emergency department and perpetuates their dependence on an exorbitant pricey part of the health care system."
Today, Peck has cut his time as an emergency surgeon in half, transitioning from a critical care surgeon to a surgeon epidemiologist leading a research team to determine how often gallstone disease occurs and how it could be treated in the community rather than surgically in the hospital. He has applied for two additional multi-million-dollar NIH grants to conduct research on a national and international level which will include studying cholesterol-lowering medications and the beneficial bacteria in the microbiome to see if gallstone disease could be preventable.
"I grew more critically objective about the holistic impact I was missing with very technical interventions often undergone too late in a patient's disease," said Peck who is also an associate professor of Health, Behavior, Society and Policy in the Rutgers School of Public Health. "I discovered that proactive surgeons who seek to reduce overall mortality by preventing patients from ever requiring emergency surgery are few. I wanted to fill this gap."
Shawna Hudson, co-director of community engagement for the New Jersey Alliance for Clinical and Transitional Science, professor of family medicine and community health and Peck's research mentor, says his expertise as a critical care surgeon provides the context needed to evaluate how effective emergency vs. elective surgery is in underrepresented and underserved communities.
"In order to devise a primary care model that works for all communities and provides the safest and highest quality of care, we need the insight of those like Dr. Peck who are on the frontline of medicine and understand that in order to create improved outcomes at the population level we need to greatly improve the way we prevent disease," said Hudson.
