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Study: Better Surgical Outcomes Depend More on Surgeon Specialization Than Volume

Surgical specialists may produce the best patient outcomes for certain surgical procedures, according to recent article in The Wall Street Journal. The finding is based on a study in the BMJ examining mortality rates for eight types of surgeries performed in the US over a five-year period. Researchers discovered that doctors who specialized in a specific procedure had lower rates of patient morality than those with more general experience, even if they were active surgeons with high care volumes.

For the eight procedures studied, the most substantial results were for valve replacement, abdominal aortic aneurysm repair, and cystectomy, for which specialized surgeons had mortality risk reductions of 46, 42, and 41 percent, respectively, compared to general surgeons. The importance of specialization compared to absolute procedure volume was most pronounced for cystectomy and least significant for coronary artery bypass grafting.

The researchers offer a few possible explanations for the difference in care. One is that certain procedures may require specialized skills that are honed through repetition, and these skills could be diluted if surgeons are required to perform other types of surgeries with other specific demands. Another is that specialized surgeons may pay more attention to evolving science and medical developments that can improve outcomes. Regardless of the exact reason, the finding is persuasive and suggests patients should take a physician’s experience performing a specific surgery into account when receiving care.

Selected procedures from study, estimated annual volume, 2014

ICD 9 Codes Estimated Volume*
Abdominal aortic aneurysm repair 39.71 35,970
Carotid Endarterectomy 38.12 97,874
Coronary artery bypass grafting 36.1 432,939
Cystectomy 57.6, 57.7 17,721
Esophagectomy 42.4 5,531
Lung resection 32 116,775
Pancreatic resection 52.5, 52.6, 52.7 25,546

Source: Definitive Healthcare
*Estimates derived from Definitve Healthcare algorithms

Definitive Healthcare has the most up-to-date, comprehensive and integrated data on over 7,700 hospitals, 1.4 million physicians, and numerous other healthcare providers.  Users can search for physicians and hospitals by procedure code, volume, reimbursement amount, as well as several other variables using Definitive Healthcare’s analytics features.

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