A survey of oral and maxillofacial surgeons concerning their knowledge, beliefs, attitudes, and behavior relative to parameters of care

Abstract

In December 1990, a survey was sent to 1,296 randomly selected members of the American Association of Oral and Maxillofacial Surgeons (AAOMS) to determine their previous experience with standards and criteria of care, their type of practice, the educational methods that influence their professional decisions, and their attitudes about the development and use of parameters of care. A 55.7% response was obtained. This article reports the results of this survey. The average age of responding surgeons was 45 years and they had been in practice an average of 15 years. The majority were in private practice, had hospital staff privileges, worked between 31 and 55 hours per week, spent 90% of their working week in direct patient care, and devoted an average of 9.16 hours per month to professional affairs outside of their practice. Forty-two percent (42%) of the practitioners were in solo practice, whereas 50% practiced in groups. Surgeons concentrated 65% of their patient care time on dentoalveolar surgery and a significant number planned increases in practice activity in implant, orthognathic, and temporomandibular joint surgery. They learned new clinical skills in various ways, there being a difference between the most convenient and effective methods of learning. A majority of surgeons had been involved with quality assurance activities in the past 5 years. They were predominantly favorable to parameters now and when they first learned about them, but few thought they had a clear understanding about how parameters of care would be used. Their opinions concerning the usefulness of parameters of care in such matters as obtaining privileges, defining the scope of practice, defending professional liability suits, obtaining reimbursement, and residency education were positive but variable. Surgeons believed that other professionals should be involved in the development of oral and maxillofacial surgery parameters but were more enthusiastic about specialist than generalist participation. Ninety-two percent (92%) of the respondents were willing to participate anonymously in the collection of outcome data from their practices, whereas 95.7% would like to draw information about treatment methods and outcomes from a confidential AAOMS data base if one was available. Seventy-five percent believed that collecting patient outcome data would have a favorable effect on quality of care. When asked to identify those clinical areas and clinical conditions in which to begin the collection of patient outcome data, the respondents' order of preference was temporomandibular joint surgery, anesthesia, orthognathic surgery, and implant surgery.