TY - JOUR
T1 - Specialization and the current practices of general surgeons
AU - Decker, Marquita R.
AU - Dodgion, Christopher M.
AU - Kwok, Alvin C.
AU - Hu, Yue Yung
AU - Havlena, Jeff A.
AU - Jiang, Wei
AU - Lipsitz, Stuart R.
AU - Kent, K. Craig
AU - Greenberg, Caprice C.
N1 - Funding Information:
Dr Decker is supported by an NIH T32 Surgical Oncology Research Training Grant T32CA090217 ; Dr Dodgion was supported by the Brigham and Women's Hospital, Center for Surgery and Public Health, Arthur Tracy Cabot Fellowship , and an NIH Surgical Oncology Research Training Grant ( T32 CA009535-23 ); and Dr Hu was supported by an NIH Alimentary Tract Surgery Research Training Grant ( 2T32DK00754-12 ).
PY - 2014/1
Y1 - 2014/1
N2 - 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.
AB - 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.
UR - http://www.scopus.com/inward/record.url?scp=84890797040&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84890797040&partnerID=8YFLogxK
U2 - 10.1016/j.jamcollsurg.2013.08.016
DO - 10.1016/j.jamcollsurg.2013.08.016
M3 - Article
AN - SCOPUS:84890797040
SN - 1072-7515
VL - 218
SP - 8
EP - 15
JO - Journal of the American College of Surgeons
JF - Journal of the American College of Surgeons
IS - 1
ER -