Specialization and the current practices of general surgeons. J Am Coll Surg 2014 Jan;218(1):8-15
Date
11/12/2013Pubmed ID
24210145Pubmed Central ID
PMC3894924DOI
10.1016/j.jamcollsurg.2013.08.016Scopus ID
2-s2.0-84890797040 (requires institutional sign-in at Scopus site) 70 CitationsAbstract
BACKGROUND: The impact of specialization on the practice of general surgery has not been characterized. Our goal was to assess general surgeons' operative practices to inform surgical education and workforce planning.
STUDY DESIGN: We examined the practices of general surgeons identified in the 2008 State Inpatient and Ambulatory Surgery Databases of the Healthcare Cost and Utilization Project for 3 US states. Operations were identified using ICD-9 and CPT codes linked to encrypted physician identifiers. For each surgeon, total operative volume and percentage of practice that made up their most common operation were calculated. Correlation was measured between general surgeons' case volume and the number of other specialists in a health service area.
RESULTS: There were 1,075 general surgeons who performed 240,510 operations in 2008. The mean operative volume for each surgeon was 224 annual procedures. General surgeons performed an average of 23 different types of operations. For the majority of general surgeons, their most common procedure constituted no more than 30% of total practice. The most common operations, ranked by the frequency they appeared as general surgeons' top procedure, included cholecystectomy, colonoscopy, endoscopy, and skin excision. The proportion of general surgery practice composed of endoscopic procedures inversely correlated with the number of gastroenterologists in the health service area (rho = -0.50; p = 0.005).
CONCLUSIONS: Despite trends toward specialization, the current practices of general surgeons remain heterogeneous. This indicates a continued demand for broad-based surgical education to allow future surgeons to tailor their practices to their environment.
Author List
Decker MR, Dodgion CM, Kwok AC, Hu YY, Havlena JA, Jiang W, Lipsitz SR, Kent KC, Greenberg CCAuthor
Christopher M. Dodgion MD Associate Professor in the Surgery department at Medical College of WisconsinMESH terms used to index this publication - Major topics in bold
Cohort StudiesGeneral Surgery
Humans
Practice Patterns, Physicians'
Retrospective Studies
Specialization
Surgical Procedures, Operative
United States