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Specialization and the current practices of general surgeons
Marquita R Decker1, Christopher M Dodgion1, Alvin C Kwok2
1Wisconsin Surgical Outcomes Research (WiSOR) Program, Department of Surgery, University of Wisconsin School of Medicine and Public Health, Madison, WI.
Journal of the American College of Surgeons
|November 12, 2013
Summary
General surgeons perform a wide variety of operations, with most procedures comprising less than 30% of their practice. This heterogeneity highlights the need for broad surgical education to meet diverse practice needs.
Area of Science:
- Surgery
- Surgical Practice
- Healthcare Workforce Analysis
Background:
- Specialization's impact on general surgery practice remains unclear.
- Understanding current general surgeon operative practices is crucial for education and workforce planning.
Purpose of the Study:
- To characterize the operative practices of general surgeons.
- To inform surgical education and workforce planning strategies.
Main Methods:
- Analysis of 2008 State Inpatient and Ambulatory Surgery Databases from 3 US states.
- Identification of 1,075 general surgeons and 240,510 operations using ICD-9 and CPT codes.
- Calculation of individual surgeon operative volume and practice diversity; correlation analysis with specialist density.
Main Results:
- General surgeons performed a mean of 224 operations annually across an average of 23 different procedure types.
- The most common procedures for general surgeons included cholecystectomy, colonoscopy, endoscopy, and skin excision.
- A higher number of gastroenterologists correlated with a lower proportion of endoscopic procedures in general surgery practices (rho = -0.50; p = 0.005).
Conclusions:
- General surgery practices remain heterogeneous despite specialization trends.
- A continued demand exists for broad-based surgical education to equip surgeons for diverse practice environments.
