OC-058 A survey of surgeon specific outcome data and their potential impact on surgical training

Abstract

Introduction The publication of surgeon specific data (SSD) for general surgeons at the end of 2013 started a new era in surgery in the UK. It is not known if and how this will impact surgical practice and training particularly with respect to high-risk cases. We aimed to explore the consultants’ perception and their potential changes in their practice as a result of SSD publication. Method A cross sectional on-line survey was sent to a sample of General Surgeons with an interest in Upper GI surgery. Details of their current surgical practice and their opinions on the changes they would make in clinical practice and training were collected. Questions were themed and data analysed both qualitatively and quantitatively. Results Eighty nine surgeons responded to the questionnaire. Of those 61 (68.5%) were cancer surgeons and 28 (31.5%) described themselves as a benign (including bariatric) surgeon. Thirty six (40%) surgeons considered SSD to be of no benefit at all to surgical training while 21 (23.5%) thought there will be some useful effect. Asked whether there was any negative effect on training, 33 surgeons (37%) thought there will be a detrimental effect on surgical training in general, and 25 (75%) of those thought this effect will be mainly on complex cases. However, when asked to specify the negative effects on surgical training 55 (73%) of the group said the number of complex operations done by trainees will drop and 35 (46%) thought the number of all operation done by trainees will drop. A significant point was the attitude toward trainees where 32 (36%) surgeons said they will perform major or complex cases themselves with 13 (14%) choosing the option of performing all cases themself. Upon asking about any general changes to practice, 11 (12.5%) said they will give up or reduce high risk surgery and 32 (36%) thought their practice will not change. Regarding the patients’ outcome 49 (55%) thought that SSD will improve outcomes while 40 (45%) answered that they will not change outcomes. Qualitative assessment, using content analysis technique, showed a minority of the surgeons will either avoid training their trainees in high risk patients and/or avoid high risk cases in order to maintain their SSD data reputation. Conclusion The publication of surgeons’ specific data will result in some changes to general surgical practice. It is too early to decide whether these effects are good for training, however, if these initial opinions are applied to routine practice then trainees may be faced with large scale reductions in training cases particularly those of a complex nature that would have major ramifications on surgical training. As the shape of surgical training continues to be developed it is important that the implications of SSD on surgical training are considered. Disclosure of interest None Declared.