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Trends in general surgeon operative practice patterns in a modern cohort
Drew Goldberg1, James Sharpe2, Emna Bakillah1
1Center for Surgery and Health Economics, University of Pennsylvania, USA; Department of Surgery, Hospital of the University of Pennsylvania, USA.
Introduction:
Analyzing general surgeons' operative case mix can provide an update on contemporary practice patterns and inform pragmatic residency training.
Methods:
We performed a retrospective cohort study of general surgeons in Florida, Iowa, and Maryland, 2016-2020. Cases were identified using billing codes. The Cochran-Armitage test of trends was used to evaluate the proportion of practice devoted to specific case types and operative setting over time.
Results:
General surgeons (n = 1300) performed 1,287,745 cases. The mean (±SD) annual volume per surgeon for all procedures was 356 (±250), with 198 (±152) general surgery operations, 57 (±142) endoscopic procedures, and 101 (±109) other cases. On average, surgeons operated on 7.1 (±2.6) different organ systems. Trends toward a lower proportion of general surgery operations, and a greater proportion of subspecialty procedures and surgery in the outpatient setting over time were demonstrated (p < 0.001).
Conclusion:
The practice pattern of the general surgeon continues to be heterogeneous, reflecting the persistent need for a broad training paradigm that permits specialization.
