8551 Investigating the Impact of the Addition of a MIGS Surgeon on Surgical Volume of General Obstetrics and Gynecologys

Abstract

Study Objective The primary objective was to determine whether adding a fellowship-trained minimally invasive gynecologic surgeon (FMIGS) would decrease the surgical volumes of physicians in other subspecialties within an academic obstetrics and gynecology (Obstetrics and Gynecology) department. Design The study compared case type and quantity, and case minutes of general Obstetrics and Gynecology, Female Pelvic Medicine & Reconstructive Surgery (FPMRS), and Reproductive Endocrinology & Infertility (REI) physicians before and after the addition of a FMIGS-trained surgeon. “Before” was academic years 2015-16 and 2016-17. “After” was academic years 2017-18, 2018-19, 2019-20, and 2020-21. Setting An academic Obstetrics and Gynecology department that grew from twelve to twenty surgeons from AY 2015-21. Patients or Participants All general Obstetrics and Gynecology, REI, and FPMRS physicians within an academic Obstetrics and Gynecology department. Interventions Surgical data including numbers of surgeries, categorized by major and minor, with and without endometriosis, and total case minutes from all general Obstetrics and Gynecology, REI, and FPMRS physicians from AY 2015-21 were collected for each academic year. Clinical full-time equivalents (FTE) per academic year, adjusted for hire date and medical leaves, were also collected. Major cases included hysterectomy, laparoscopic or abdominal myomectomy, and sacrocolpopexy. Minor cases included other laparoscopies, hysteroscopy, dilation and curettage, and suburethral slings. Endometriosis had its own sub-category due to the wide range of associated surgical interventions. Measurements and Main Results The FMIGS surgical volume grew from 95 cases to 213 cases in four years. Case volumes did not change for any subspecialty after the hire of the FMIGS surgeon, with and without adjustment for FTE, or when sub-categorized into major, minor, and endometriosis cases. Case duration did not show any change before and after the addition of the FMIGS surgeon. Conclusion The addition of a FMIGS-trained surgeon to this department's surgical practice did not decrease surgical volumes for the other sub-specialties. This information can help overcome concerns of other members of the faculty when considering whether to hire a FMIGS-trained surgeon. The primary objective was to determine whether adding a fellowship-trained minimally invasive gynecologic surgeon (FMIGS) would decrease the surgical volumes of physicians in other subspecialties within an academic obstetrics and gynecology (Obstetrics and Gynecology) department. The study compared case type and quantity, and case minutes of general Obstetrics and Gynecology, Female Pelvic Medicine & Reconstructive Surgery (FPMRS), and Reproductive Endocrinology & Infertility (REI) physicians before and after the addition of a FMIGS-trained surgeon. “Before” was academic years 2015-16 and 2016-17. “After” was academic years 2017-18, 2018-19, 2019-20, and 2020-21. An academic Obstetrics and Gynecology department that grew from twelve to twenty surgeons from AY 2015-21. All general Obstetrics and Gynecology, REI, and FPMRS physicians within an academic Obstetrics and Gynecology department. Surgical data including numbers of surgeries, categorized by major and minor, with and without endometriosis, and total case minutes from all general Obstetrics and Gynecology, REI, and FPMRS physicians from AY 2015-21 were collected for each academic year. Clinical full-time equivalents (FTE) per academic year, adjusted for hire date and medical leaves, were also collected. Major cases included hysterectomy, laparoscopic or abdominal myomectomy, and sacrocolpopexy. Minor cases included other laparoscopies, hysteroscopy, dilation and curettage, and suburethral slings. Endometriosis had its own sub-category due to the wide range of associated surgical interventions. The FMIGS surgical volume grew from 95 cases to 213 cases in four years. Case volumes did not change for any subspecialty after the hire of the FMIGS surgeon, with and without adjustment for FTE, or when sub-categorized into major, minor, and endometriosis cases. Case duration did not show any change before and after the addition of the FMIGS surgeon. The addition of a FMIGS-trained surgeon to this department's surgical practice did not decrease surgical volumes for the other sub-specialties. This information can help overcome concerns of other members of the faculty when considering whether to hire a FMIGS-trained surgeon.