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When it comes to surgery, does practice make perfect?

If you have an upcoming surgery, you're likely concerned over any number of issues. Whether your procedure is large or small, you're probably worrying about things like pain and recovery time. One thing you shouldn't have to worry over, though, is whether your surgeon has enough experience to safely perform the operation. Unfortunately, it appears this concern may be a valid one.

Generally, larger hospitals have surgeons on staff who have experience or even specialize in performing certain complex procedures. In smaller areas, however, an inexperienced doctor may not have the practice to do as skilled a job. Is that a risk you want to take, either with your own health or with the life of someone you love? Is there anything you, the patient, can do to avoid this risk of a botched surgical procedure by an inexperienced surgeon?

Experience matters

Imagine receiving a diagnosis of a specific, complex type of cancer, scheduling the necessary, life-saving operation and going through the time, preparation, finances and stress, only to have a surgeon abort the procedure at the last minute when it proves too difficult. Worse yet, imagine if the surgeon had gone through with the surgery, and you or your loved one had paid with your health, or even your life. Frighteningly, these scenarios are far from theoretical.

Surgeons are frequently permitted, with little to no oversight, to perform high-risk procedures for which they have little expertise and minimal experience. This subject is beginning to garner attention, given research from several studies:

  • Findings from a 1979 Stanford study indicated that patients who underwent surgeries at hospitals that had performed more of those operations had a notably lower death rate than patients at hospitals where such surgeons performed those procedures infrequently.
  • A more recent study replicated these findings repeatedly across a number of specialties, and found that it applied to surgeons and not just hospitals.
  • Another larger study then discovered that the risk of complication rose drastically among surgeons who only performed a tricky thyroid removal procedure once a year, compared to surgeons who performed 25 or more annually.

Clearly, experience is directly linked to a standard of care that you and other patients have the right to expect. So is anything being done to address this issue? Well, for starters, a group of leading health care systems, including Johns Hopkins, has introduced something they're calling the volume pledge, requiring affiliated surgeons and hospitals to meet certain minimum thresholds for 10 of the highest-risk surgical procedures. This first-of-its-kind volume pledge includes the following stipulations:

  • In hospitals that perform 20 pancreatic cancer operations annually, each on-staff surgeon must perform a minimum of five such surgeries every year.
  • In hospitals that perform 50 knee or hip replacements each year, surgeons must perform at least 25 such procedures annually.
  • In cases of emergency surgery or for surgeons who would not meet this threshold due to leave, the hospitals might require supervision when such surgeons perform these procedures.

The hope is that this will prevent inexperienced or out-of-practice surgeons from performing high-risk surgeries when they're simply not qualified, which in turn may prevent serious mistakes and save lives.

Avoiding surgical errors and where to turn as a victim

Whether hospitals everywhere adopt this strategy remains to be seen. Meanwhile, good sense would indicate that if you find yourself needing complex surgery, you may want to research hospitals and surgeons and search out the most experienced possible to oversee your operation. Of course, if you've already been the victim of a surgical error and suffered serious injury as a result, it's a little late for such advice. In these unfortunate situations, there are legal resources in Ohio that focus on medical malpractice and can offer counsel and support.

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