Practice Patterns Of Surgeons Research Articles

How practice patterns in lung cancer patient follow-up are affected by surgeon age

Strategies for the follow-up of lung cancer patients after potentially curative treatment are known to vary widely. The optimal regimen remains unknown. We investigated whether the age of the surgeon affects choice of surveillance strategy. The 3,700 members of the Society of Thoracic Surgeons (STS) were surveyed using a detailed questionnaire to measure how these surgical experts deal with lung cancer patient follow-up. Subjects were asked how they use 10 specific follow-up modalities during years 1-5 following primary treatment for patients with lung cancer (TNM stages I-III). Repeated-measures analysis of variance was used to compare practice patterns by surgeon age, as well as by TNM stage and year post-surgery. Evaluable responses from 768 STS members (21%) were received. Follow-up strategies for most of the ten modalities were highly correlated across TNM stages and years post-surgery, as expected. The pattern of testing varied significantly by surgeon age for only one modality (LFTs). Even in this instance, the absolute differences in surveillance strategies among age groups were small. This analysis indicates that the post-treatment surveillance practice patterns of surgeons caring for patients with lung cancer do not vary substantially with practitioner age. The data provide credible evidence that post-graduate education is effective in homogenizing practitioner behavior.

How practice patterns in colon cancer patient follow-up are affected by surgeon age

Strategies for the follow-up of colon cancer patients after potentially curative treatment are known to vary widely. The optimal regimen remains unknown. We investigated whether the date of completion of formal surgical training affects choice of surveillance strategy. The 1070 members of the Society of Surgical Oncology (SSO) and the 1663 members of the American Society of Colon and Rectal Surgeons (ASCRS) were surveyed using a detailed questionnaire to measure how these surgical experts deal with colon cancer follow-up. Subjects were asked how they use nine specific follow-up modalities during years 1-5 following primary treatment for patients with colon cancer (TNM Stages I-III). Repeated-measures analysis of variance was used to compare practice patterns by TNM stage and year post-surgery, as well as by the year in which the surgeon's formal surgery training was completed. Evaluable responses were received from 349 SSO members (33%) and 646 ASCRS members (39%). Few significant differences in follow-up practices were noted by training period, but follow-up for most of the nine modalities was highly correlated with TNM stage and year post-surgery, as expected. This analysis indicates that the post-treatment surveillance practice patterns of surgeons caring for patients with colon cancer do not vary substantially with practitioner age. The data provide credible evidence that postgraduate education is effective in homogenizing practitioner behaviour.

The impact of pediatric surgery training on the attitudes and practice patterns of general surgeons

In order to evaluate how experience in pediatric surgery during residency training affects attitudes and practice patterns of general surgeons, questionnaires were sent to the 51 residents who graduated from our general surgical residency program since the establishment of a Section of Pediatric Surgery in 1974. There were 51 respondents (100%) of whom 50 were male and 1 female. Three were pediatric surgeons and their responses to the questionnaire were not included in the analysis. During the past year, 29 of the respondents had performed from 2 to 55 pediatric operations, with a mean of 23.7. Most of these were herniorrhaphies, appendectomies, and sub-specialty cases. Thirty-two of the 48 respondents referred most pediatric cases to a board certified pediatric surgeon nearby. Ninety-two percent of the respondents indicated that pediatric surgery rotations were of great value in their training (6.3 mean response on a scale of 7) and 92% felt that pediatric surgery was a necessary part of a general surgery training program. Respondents had a mean exposure of 1.8 mo to pediatric surgery as junior residents, and 2.1 mo as senior residents; 90% felt that their operative experience was good to excellent (5.5 mean on a scale of 7). Most respondents felt qualified to do many more pediatric procedures than they actually performed; however, their perception was that these cases were best done by fully trained pediatric surgeons. The 51 graduates of our general surgical residency program considered pediatric surgery an important factor in the development of their technical skills and surgical judgment.