Most Americans fear having surgery regardless of how complicated the surgery is, because of the fatal consequences that could ensue. But are your chances of surviving better if you have an experienced surgeon?
Reuters reports in a new study.
The new data shows that surgeons who have more experience have much better results than new surgeons on average.
Experts are urging patients to research their surgeons (to see how many surgeons they have performed and what their fatality rates are) before picking one for their procedure. The data from this study showed that the more procedures surgeons have performed, the better their patients’ outcomes. This is true at least until the doctors hit a learning plateau.
The experts reviewed more than one million surgeries before they came to this analysis. They found that the flattening out of the learning curve happens at different points, ranging from 25 to 750 procedures, for different forms of surgery.
Dr. Gilbert of Harvard University was one of the authors of the study and explained his findings to Reuters.
He said, “For the past two decades or so, many researchers have acknowledged that a surgeon’s experience is related to his or her performance. But studies in the area have been inconsistent, so there has not been many practice guidelines based on the learning curve data. Our results are exciting and, we hope, will be used to shape the surgical training programs of the future.”
How was the study conducted?
The researchers analyzed the results of 57 recent studies of surgical performance. The study was conducted in 14 countries with a total of more than 17,000 surgeons and 35 different types of surgeries.
The majority of the studies of this type measured the volume of cases a surgeon handled, and some also included years of practice. In over forty studies, researchers found that the amount of time procedures took, rates of recurrence of the condition, complication rates, requirements for blood transfusions, mortality and stroke rates all faired better as the surgeon’s number of past surgeries increased.
Dr. Gilbert said, “Of all the studies included in our review, only two showed the surgical learning curve 'leveling out', where increased experience failed to improve operative outcomes. The time at which this plateau occurred was procedure-specific, taking approximately 12 years of experience in the case of bilateral reduction mammoplasty and somewhere between 5 and 20 years for thyroidectomies, for example.”
A few studies did find an insignificant learning curve. One of them focused on off-pump coronary artery bypass graft surgery found that factors like patient heart failure, renal failure, type of bypass and sex were more important predictors of outcome than surgeon experience. These results were published in the Annals of Surgery. But these ratings are based on online satisfaction reviews.
If patients were to find experienced surgeons then they are suggested to go to large, specialist centers, in centralized hospitals. If a patient is trying to figure out how experienced a surgeon is then they should look at a surgeon’s experience at performing a specific procedure, and find patients more overt risk-related metrics such as estimated complication rates. Patients can also look at a range of quality measures at the hospital where surgery is being performed.