Bariatric surgery and the changing current scope of general surgery practice: Implications for general surgery residency training

Rouzbeh Mostaedi, Mohamed R Ali, Jonathan L Pierce, Lynette A. Scherer, Joseph M Galante

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

IMPORTANCE: The scope of general surgery practice has evolved tremendously in the last 20 years. However, clinical experience in general surgery residency training has undergone relatively little change. OBJECTIVE: To evaluate the current scope of academic general surgery and its implications on surgical residency. DESIGN, SETTING, AND PARTICIPANTS: The University HealthSystem Consortium and Association of American Medical Colleges established the Faculty Practice Solution Center (FPSC) to characterize physician productivity. The FPSC is a benchmarking tool for academic medical centers created from revenue data collected from more than 90 000 physicians who practice at 95 institutions across the United States. MAIN OUTCOMESAND MEASURES: The FPSC database was queriedtoevaluate the annual mean procedure frequency per surgeon (PFS) in each calendar year from 2006 through 2011. The associated work relative value units (wRVUs) were also examined to measure physician effort and skill. RESULTS: During the 6-year period, 146 distinct Current Procedural Terminology codes were among the top 100 procedures, and 16 of theseprocedures ranked in the top 10 procedures in at least 1 year. The top 10 procedures accounted for more than half (range, 52.5%-57.2%) of the total 100 PFS evaluated for each year. Laparoscopic Roux-en-Y gastric bypass was consistently among the top 10 procedures in each year (PFS, 18.2-24.6). The other most frequently performed procedures included laparoscopic cholecystectomy (PFS, 30.3-43.5), upper gastrointestinal tract endoscopy (PFS, 26.5-34.3), mastectomy (PFS, 16.5-35.0), inguinal hernia repair (PFS, 15.5-22.1), and abdominal wall hernia repair (PFS, 21.6-26.1). In all years, laparoscopic Roux-en-Y gastric bypass generated the highest number of wRVUs (wRVUs, 491.0-618.2), and laparoscopic cholecystectomy was regularly the next highest (wRVUs, 335.8-498.7). CONCLUSIONS AND RELEVANCE: A significant proportion of academic general surgery is composed of bariatric surgery, yet surgical training does not sufficiently emphasize the necessary exposure to technical expertise and clinical management of the patient undergoing bariatric surgery. As the scope of general surgery practice continues to evolve, general surgery residency training will need to better integrate the exposure to bariatric surgery.

Original languageEnglish (US)
Pages (from-to)144-151
Number of pages8
JournalJAMA Surgery
Volume150
Issue number2
DOIs
StatePublished - Feb 1 2015

Fingerprint

Bariatric Surgery
Internship and Residency
General Practice
Gastric Bypass
Herniorrhaphy
Laparoscopic Cholecystectomy
Physicians
Current Procedural Terminology
Abdominal Hernia
Professional Competence
Benchmarking
Upper Gastrointestinal Tract
Gastrointestinal Endoscopy
Surgeons
Inguinal Hernia
Mastectomy
American Medical Association
Abdominal Wall

ASJC Scopus subject areas

  • Surgery

Cite this

Bariatric surgery and the changing current scope of general surgery practice : Implications for general surgery residency training. / Mostaedi, Rouzbeh; Ali, Mohamed R; Pierce, Jonathan L; Scherer, Lynette A.; Galante, Joseph M.

In: JAMA Surgery, Vol. 150, No. 2, 01.02.2015, p. 144-151.

Research output: Contribution to journalArticle

@article{6ee3a13578144c799a956a01f7495fa9,
title = "Bariatric surgery and the changing current scope of general surgery practice: Implications for general surgery residency training",
abstract = "IMPORTANCE: The scope of general surgery practice has evolved tremendously in the last 20 years. However, clinical experience in general surgery residency training has undergone relatively little change. OBJECTIVE: To evaluate the current scope of academic general surgery and its implications on surgical residency. DESIGN, SETTING, AND PARTICIPANTS: The University HealthSystem Consortium and Association of American Medical Colleges established the Faculty Practice Solution Center (FPSC) to characterize physician productivity. The FPSC is a benchmarking tool for academic medical centers created from revenue data collected from more than 90 000 physicians who practice at 95 institutions across the United States. MAIN OUTCOMESAND MEASURES: The FPSC database was queriedtoevaluate the annual mean procedure frequency per surgeon (PFS) in each calendar year from 2006 through 2011. The associated work relative value units (wRVUs) were also examined to measure physician effort and skill. RESULTS: During the 6-year period, 146 distinct Current Procedural Terminology codes were among the top 100 procedures, and 16 of theseprocedures ranked in the top 10 procedures in at least 1 year. The top 10 procedures accounted for more than half (range, 52.5{\%}-57.2{\%}) of the total 100 PFS evaluated for each year. Laparoscopic Roux-en-Y gastric bypass was consistently among the top 10 procedures in each year (PFS, 18.2-24.6). The other most frequently performed procedures included laparoscopic cholecystectomy (PFS, 30.3-43.5), upper gastrointestinal tract endoscopy (PFS, 26.5-34.3), mastectomy (PFS, 16.5-35.0), inguinal hernia repair (PFS, 15.5-22.1), and abdominal wall hernia repair (PFS, 21.6-26.1). In all years, laparoscopic Roux-en-Y gastric bypass generated the highest number of wRVUs (wRVUs, 491.0-618.2), and laparoscopic cholecystectomy was regularly the next highest (wRVUs, 335.8-498.7). CONCLUSIONS AND RELEVANCE: A significant proportion of academic general surgery is composed of bariatric surgery, yet surgical training does not sufficiently emphasize the necessary exposure to technical expertise and clinical management of the patient undergoing bariatric surgery. As the scope of general surgery practice continues to evolve, general surgery residency training will need to better integrate the exposure to bariatric surgery.",
author = "Rouzbeh Mostaedi and Ali, {Mohamed R} and Pierce, {Jonathan L} and Scherer, {Lynette A.} and Galante, {Joseph M}",
year = "2015",
month = "2",
day = "1",
doi = "10.1001/jamasurg.2014.2242",
language = "English (US)",
volume = "150",
pages = "144--151",
journal = "JAMA Surgery",
issn = "2168-6254",
publisher = "American Medical Association",
number = "2",

}

TY - JOUR

T1 - Bariatric surgery and the changing current scope of general surgery practice

T2 - Implications for general surgery residency training

AU - Mostaedi, Rouzbeh

AU - Ali, Mohamed R

AU - Pierce, Jonathan L

AU - Scherer, Lynette A.

AU - Galante, Joseph M

PY - 2015/2/1

Y1 - 2015/2/1

N2 - IMPORTANCE: The scope of general surgery practice has evolved tremendously in the last 20 years. However, clinical experience in general surgery residency training has undergone relatively little change. OBJECTIVE: To evaluate the current scope of academic general surgery and its implications on surgical residency. DESIGN, SETTING, AND PARTICIPANTS: The University HealthSystem Consortium and Association of American Medical Colleges established the Faculty Practice Solution Center (FPSC) to characterize physician productivity. The FPSC is a benchmarking tool for academic medical centers created from revenue data collected from more than 90 000 physicians who practice at 95 institutions across the United States. MAIN OUTCOMESAND MEASURES: The FPSC database was queriedtoevaluate the annual mean procedure frequency per surgeon (PFS) in each calendar year from 2006 through 2011. The associated work relative value units (wRVUs) were also examined to measure physician effort and skill. RESULTS: During the 6-year period, 146 distinct Current Procedural Terminology codes were among the top 100 procedures, and 16 of theseprocedures ranked in the top 10 procedures in at least 1 year. The top 10 procedures accounted for more than half (range, 52.5%-57.2%) of the total 100 PFS evaluated for each year. Laparoscopic Roux-en-Y gastric bypass was consistently among the top 10 procedures in each year (PFS, 18.2-24.6). The other most frequently performed procedures included laparoscopic cholecystectomy (PFS, 30.3-43.5), upper gastrointestinal tract endoscopy (PFS, 26.5-34.3), mastectomy (PFS, 16.5-35.0), inguinal hernia repair (PFS, 15.5-22.1), and abdominal wall hernia repair (PFS, 21.6-26.1). In all years, laparoscopic Roux-en-Y gastric bypass generated the highest number of wRVUs (wRVUs, 491.0-618.2), and laparoscopic cholecystectomy was regularly the next highest (wRVUs, 335.8-498.7). CONCLUSIONS AND RELEVANCE: A significant proportion of academic general surgery is composed of bariatric surgery, yet surgical training does not sufficiently emphasize the necessary exposure to technical expertise and clinical management of the patient undergoing bariatric surgery. As the scope of general surgery practice continues to evolve, general surgery residency training will need to better integrate the exposure to bariatric surgery.

AB - IMPORTANCE: The scope of general surgery practice has evolved tremendously in the last 20 years. However, clinical experience in general surgery residency training has undergone relatively little change. OBJECTIVE: To evaluate the current scope of academic general surgery and its implications on surgical residency. DESIGN, SETTING, AND PARTICIPANTS: The University HealthSystem Consortium and Association of American Medical Colleges established the Faculty Practice Solution Center (FPSC) to characterize physician productivity. The FPSC is a benchmarking tool for academic medical centers created from revenue data collected from more than 90 000 physicians who practice at 95 institutions across the United States. MAIN OUTCOMESAND MEASURES: The FPSC database was queriedtoevaluate the annual mean procedure frequency per surgeon (PFS) in each calendar year from 2006 through 2011. The associated work relative value units (wRVUs) were also examined to measure physician effort and skill. RESULTS: During the 6-year period, 146 distinct Current Procedural Terminology codes were among the top 100 procedures, and 16 of theseprocedures ranked in the top 10 procedures in at least 1 year. The top 10 procedures accounted for more than half (range, 52.5%-57.2%) of the total 100 PFS evaluated for each year. Laparoscopic Roux-en-Y gastric bypass was consistently among the top 10 procedures in each year (PFS, 18.2-24.6). The other most frequently performed procedures included laparoscopic cholecystectomy (PFS, 30.3-43.5), upper gastrointestinal tract endoscopy (PFS, 26.5-34.3), mastectomy (PFS, 16.5-35.0), inguinal hernia repair (PFS, 15.5-22.1), and abdominal wall hernia repair (PFS, 21.6-26.1). In all years, laparoscopic Roux-en-Y gastric bypass generated the highest number of wRVUs (wRVUs, 491.0-618.2), and laparoscopic cholecystectomy was regularly the next highest (wRVUs, 335.8-498.7). CONCLUSIONS AND RELEVANCE: A significant proportion of academic general surgery is composed of bariatric surgery, yet surgical training does not sufficiently emphasize the necessary exposure to technical expertise and clinical management of the patient undergoing bariatric surgery. As the scope of general surgery practice continues to evolve, general surgery residency training will need to better integrate the exposure to bariatric surgery.

UR - http://www.scopus.com/inward/record.url?scp=84923271249&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84923271249&partnerID=8YFLogxK

U2 - 10.1001/jamasurg.2014.2242

DO - 10.1001/jamasurg.2014.2242

M3 - Article

C2 - 25535681

AN - SCOPUS:84923271249

VL - 150

SP - 144

EP - 151

JO - JAMA Surgery

JF - JAMA Surgery

SN - 2168-6254

IS - 2

ER -