Related Experiment Videos
Who performs endocrine operations in the United States?
Brian D Saunders1, Reid M Wainess, Justin B Dimick
1Department of Surgery, Divisions of Endocrine Surgery and Vascular Surgery, University of Michigan, 1500 E. Medical Center Drive, Taubman Center 2920H, Ann Arbor, MI 48109-0331, USA.
Surgery
|December 12, 2003
Summary
Most endocrine surgeries are performed by general surgeons, not endocrine specialists. This highlights a gap in specialized practice despite the field's focus on high-quality patient care.
Area of Science:
- Endocrine Surgery
- Surgical Practice Patterns
Background:
- Endocrine surgery aims for high-quality patient care.
- The relationship between the "identity" of endocrine surgery as a distinct field and actual clinical practice patterns remains unclear.
Purpose of the Study:
- To investigate the practice patterns of surgeons performing common endocrine operations.
- To understand the distribution of endocrine surgical procedures among different surgical specialties.
Main Methods:
- Analysis of the National Inpatient Sample (1988-2000) using International Classification of Diseases-9th revision-Clinical Modification codes for parathyroidectomy, thyroidectomy, and adrenalectomy.
- Surgeons were profiled based on the percentage of endocrine procedures in their practice (Method A) and the absolute number of procedures performed (Method B).
Main Results:
- Surgeons with 25% or less endocrine procedures performed the vast majority of parathyroidectomies (78%), thyroidectomies (82%), and adrenalectomies (94%).
- Conversely, surgeons specializing in endocrine surgery (over 75% of practice) performed a small fraction of these procedures (5% parathyroidectomy, 3% thyroidectomy, 3% adrenalectomy).
Conclusions:
- The majority of common endocrine operations are performed by surgeons not primarily focused on endocrine surgery.
- This phenomenon is largely attributed to the greater number of non-endocrine surgeons compared to dedicated endocrine surgeons.
- Understanding these practice patterns is crucial for future research on surgeon volume and patient outcomes in endocrine surgery.