Abstract
BackgroundGuidelines and Class 1 evidence are strong factors that help guide surgeons’ decision-making, but dilemmas exist in selecting the best surgical option, usually without the benefit of guidelines or Class 1 evidence. A few studies have discussed the variability of surgical treatment options that are currently available, but no study has examined surgeons’ views on the influential factors that encourage them to choose one surgical treatment over another. This study examines the influential factors and the thought process that encourage surgeons to make these decisions in such circumstances.MethodsSemi-structured face-to-face interviews were conducted with 32 senior consultant surgeons, surgical fellows, and senior surgical residents at the University of Toronto teaching hospitals. An e-mail was sent out for volunteers, and interviews were audio-recorded, transcribed verbatim, and subjected to thematic analysis using open and axial coding.ResultsBroadly speaking there are five groups of factors affecting surgeons’ decision-making: medical condition, information, institutional, patient, and surgeon factors. When information factors such as guidelines and Class 1 evidence are lacking, the other four groups of factors—medical condition, institutional, patient, and surgeon factors (the last-mentioned likely being the most powerful)—play a significant role in guiding surgical decision-making.ConclusionsThis study is the first qualitative study on surgeons’ perspectives on the influential factors that help them choose one surgical treatment option over another for their patients.
Highlights
Guidelines and Class 1 evidence are strong factors that help guide surgeons’ decisionmaking, but dilemmas exist in selecting the best surgical option, usually without the benefit of guidelines or Class 1 evidence
Experience, training, expertise, research involvement, the availability of equipment and tools, financial constraints, and reimbursement issues are some of the important factors surgeons consider.[1,3,4,5,6] who were interested to participate e-mailed the coinvestigator (C.G.) who scheduled appointments with everyone who responded
With the presence of excellent working environments, availability of equipment and surgical tools, and the continuous appearance of new surgical techniques, procedures, and research, the question of which surgery would best treat a specific operable condition is a major challenge for surgeons
Summary
Semi-structured face-to-face interviews were conducted with 32 senior consultant surgeons, surgical fellows, and senior surgical residents at the University of Toronto teaching hospitals. An e-mail was sent out for volunteers, and interviews were audio-recorded, transcribed verbatim, and subjected to thematic analysis using open and axial coding
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