Surgeon Qualifications Research Articles

Evaluating Board Certification Within the Aesthetic Marketplace.

Unlike most health care sectors, patients can select an aesthetic surgery provider without considering insurance coverage. Patients therefore must be able to make informed choices regarding provider selection. Surgeon qualifications are part of the data patients evaluate in their decision making. To characterize the provider landscape that patients face, this study compares the certification requirements of various boards within the aesthetic marketplace. Four boards were identified for analysis based on a Google search of "board of plastic surgery": the American Board of Plastic Surgery (ABPS), the American Board of Cosmetic Surgery (ABCS), the American Board of Facial Plastic and Reconstructive Surgery (ABFPRS), and the American Board of Facial Cosmetic Surgery (ABFCS). Information on certification requirements was obtained from each board's official website. ABPS requires that diplomates complete an Accreditation Council for Graduate Medical Education (ACGME)-accredited plastic surgery residency, pass a written and oral examination that includes a case collection, and meet continual standards to maintain certification. ABCS and ABFCS both require an American Academy of Cosmetic Surgery (AACS) cosmetic surgery fellowship and passage of a written and oral examination. Neither board has case collection or continuing certification requirements. ABFPRS requires completion of either an ACGME-accredited otolaryngology or plastic surgery residency. Its examination process includes written and oral components as well as a case log. ABFPRS has enacted continuing certification requirements for diplomates credentialed in 2001 and later. ABPS is the only board that is a member of the American Board of Medical Specialties (ABMS). ABPS stands apart as the only board within the aesthetic marketplace with rigorous standards for precertification training, demonstrating competency through examinations and case logs, and maintaining certification. Being an ABMS member board also contributes to ABPS being the preeminent organization for identifying physicians who practice safe, effective aesthetic surgery.

Imaging Threshold for Assessment of the Correct Reduction in the Treatment of Unstable Syndesmotic Injuries - A Retrospective Analysis of 57 CT Scans.

An incongruence of the distal tibiofibular joint (TFJ) after treatment of upper ankle joint injury represents a prearthrotic deformity and must be corrected. The objectives of this study were to analyze postoperative CT scans after surgical treatment of unstable syndesmotic injuries, and to determine the prevalence of syndesmotic malreduction and its contributing factors. The specific parameters of three-dimensional imaging for objective detection of malreduction should be identified as a helpful intraoperative imaging threshold. Postoperative CT scans of 57 patients were analyzed by identifying cases requiring correction. Factors that influenced the reduction result (patient age, sex, fracture type and surgeon qualifications) were evaluated. The following CT measurements were determined: anterior (AD) and posterior tibiofibular distance (PD), TFJ width, anteroposterior fibular translation (APT), length and rotation of the fibula, position of the malleoli to the talar joint surface. A confidence interval of 95% was assumed (significance level p < 0.05). A very high proportion of the cases required revision (38.5%). Age (p=0.199), sex (p=0.752), body mass (p=0.722), and fracture type (p=0.266) had no significant influence on the reduction result. The risk of requiring correction was slightly lower for well-experienced trauma surgeons. The measurements revealed the following thresholds: AD: ø 3.2 mm (±2.2), PD: ø 5.1 mm (±2.2), TFJ: ø 3.4 mm (±1.4), APT: ø 7.9 mm (±3.5), and rotation: ø 10.7° (±6.8). The fibula was too long in 4 cases (7%) and too short in 8 cases (14%). There was a malleolar incongruence in 5 cases (8.7%). The analysis revealed a significant correlation between the ratio of the anterior and posterior tibiofibular distances and a need for correction. The ratio between the anterior and posterior tibiofibular distances in the axial sectional image is an aid for intraoperative assessment of the correct reduction in the TFJ.

ХИРУРГИЯ ПЕРВОГО КОНТАКТА ПРИ ЛЕЧЕНИИ ПАЦИЕНТОВ С ОГНЕСТРЕЛЬНЫМИ И ВЗРЫВНЫМИ РАНЕНИЯМИ КОНЕЧНО-СТЕЙ

Gunshot wounds of extremities are the most frequent among gunshot and ex-plosive injuries. Debridement is the main method of treatment of this type of damage. Surgeons of civil hospital organizations have difficulties in determining the scope of surgical intervention and the priority of the performed activities in most cases. This is due to the lack of clinical experience in providing medical care to patients with a gunshot injury. The concept of "First contact surgery" is a set of the minimum required amount of the debridement aimed at saving the patient's life and preventing the development of serious complications. The author consid-ers in details the content of each element of the debridement, options for its im-plementation, depending on the equipment of the hospital and the surgeon's qual-ifications. The main aims for the surgeon at the first contact with a patient with a gunshot injury are to stop external bleeding, determine the state of the main blood flow in the limb, eliminate uncompensated ischemia of the limb, wide the wound open, refuse the primary wound suture, perform immobilization, if neces-sary, and prescribe antibiotic therapy.

Influential Factors for Selecting a Plastic Surgeon: A National Survey in Saudi Arabia.

Introduction:Knowing what attracts cosmetic patients to a specific surgeon can help current cosmetic surgeons and aspiring ones improve themselves and better market their practice. Hence, this study aimed to investigate the influential factors when selecting an aesthetic surgeon for a cosmetic procedure in Saudi Arabia.Methods:This is a cross-sectional, nationwide study targeting the public from all regions of Saudi Arabia. The study was conducted between September 21 and October 29, 2021. The self-structured electronic survey was based on previously published studies and was revised by two academic plastic surgeons.Results:This study included a total of 7190 participants from all regions of Saudi Arabia. The most influential factor for choosing an aesthetic surgeon was the surgeon’s qualifications (39.9%), followed by friends and relatives’ advice (24%) and hospital/clinic environment (10.2%), while the number of social media followers was the least favorable factor (0.8%). Additionally, the most preferred aesthetic surgeon was a surgeon with international board certification (mean score, 4.17).Conclusions:This study showed that the most common factor for choosing an aesthetic surgeon was the surgeons’ qualifications. Thus, Saudi aesthetic surgeons and aspiring Saudi aesthetic surgeons must focus on obtaining high qualifications to attract more patients. Furthermore, an internationally board-certified surgeon is the most preferred surgeon for Saudi Arabian patients; thus, traveling abroad to world-renowned institutions is recommended.

Plastic Surgeons as Medical Directors: A Natural Transition into Medical Leadership.

With the growing complexity of the U.S. health care system, highly motivated medical directors with strong leadership skills are vital to the success of health care facilities. Presently, there are no articles assessing a plastic surgeon's qualifications for the role of medical director. In addition, there is a paucity of literature comparing the responsibilities of medical directors across various types of health care institutions. Herein, we outline why plastic surgeons have the unique skillset to succeed in this role and highlight the differences between medical director positions across the vast landscape of health care. While the intricacies of this position vary greatly across different landscapes of the health care industry, successful medical directors lead by following a set of universal principles predisposing them for success. Plastic surgeons innately exhibit a subset of particular traits deeming them suitable candidates for the medical director position. While transitioning from the role of a surgeon to that of a medical director does require some show of adaptation, plastic surgeons are ultimately highly likely to find intrinsic benefit from serving as a medical director.

Efficiency and Safety of Binocular Cataract Phacoemulsification

A literature review is presented on the comparative assessment of two options for conducting cataract phacoemulsification — monocular phacoemulsification of cataract, (delayed sequential bilateral cataract surgery, DSBCS) and binocular phacoemulsification of cataract (immediate sequential bilateral cataract surgery, ISBCS). It has been established that to date in the literature there is a sufficient amount of data indicating the positive aspects of ISBCS, associated with faster rehabilitation, better functional results, as well as time, financial, and economic aspects. The safety of ISBCS is determined by the minimum likelihood of postoperative bilateral endophthalmitis with careful selection of patients, the required surgeon qualifications and strict adherence to the surgical protocol. Comparatively, in accordance with the results obtained, postoperative refractive indices, the value of the maximum corrected distance visual acuity, the frequency of complications and the degree of patient satisfaction were the same regardless of whether the bilateral cataract surgery was performed simultaneously or sequentially. The effectiveness of ISBCS is determined by quick rehabilitation, the need for only one pair of glasses, a decrease in visits to the clinic, the absence of anisometropia between operations, as well as only one general anesthesia (if necessary). The experience of clinics where such procedures were carried out shows that after ISBCS, minor refractive errors occur, while they are almost always symmetrical, characterized by a slight deviation from the target refraction and rapid recovery of binocular and stereoscopic vision. In financial terms, in accordance with the calculations carried out, the cost of DSBCS in various countries may be higher than the cost of ISBCS by 10.8–47.9 %. In absolute terms, simultaneous cataract surgery on two eyes (Finland) saved €449 per patient in medical costs and €739 after travel and home care costs were included. Taking into account the cost of lost work time, the savings were €849 per patient. The wider distribution of ISBCS is associated with the approval of the ophthalmological community and insurance companies, as well as the development of standardized teaching materials for practicing ophthalmologists.

What's in a Name? Implicit Bias Affects Patient Perception of Surgeon Skill.

Implicit bias is the unconscious associations and beliefs held toward specific demographic groups. Instagram is commonly used by plastic surgeons to market their practice. This study investigates whether a surgeon's name on a social media platform influences perception of their competence and their likelihood of gaining a new patient. A mock Instagram post was created using before-and-after photographs of a breast augmentation patient. Eight different ethnicities were selected, and common female and male names were selected based on U.S. Census data for each ethnicity. Surveys using the Instagram post were distributed asking responders to evaluate the competency of the surgeon and how likely they are to become a patient of that plastic surgeon. The surgeon's name was the only variable in the survey. A total of 2965 survey responses were analyzed. The majority of responders were Caucasian (57 percent); 55 percent were men and 45 percent were women. Overall, competence and recruitment likelihood scores between surgeons of different ethnicities were not significantly different. Caucasian and Latinx responders both assigned higher competence and recruitment likelihood scores to their own respective ethnicities. Implicit bias plays a role in whether or not a patient is likely to seek care from a surgeon with an ethnically identifiable name. The two most common cosmetic surgery demographic groups, Caucasians and Latinxs, were also the only two ethnic groups to display in-group favoritism. Public education should be directed toward surgeon qualifications and experience in an effort to reduce implicit bias on patient decision-making.

Value of Global Surgical Activities for US Academic Health Centers: A Position Paper by the Association for Academic Surgery Global Affairs Committee, Society of University Surgeons Committee on Global Academic Surgery, and American College of Surgeons' Operation Giving Back

Academic global surgery value to low- and middle-income countries (LMICs) is increasingly understood, yet value to academic health centers (AHCs) remains unclear. A task force from the Association for Academic Surgery Global Affairs Committee and the Society for University Surgeons Committee on Global Academic Surgery designed and disseminated a survey to active US academic global surgeons. Questions included participant characteristics, global surgeon qualifications, trainee interactions, academic output, productivity challenges, and career models. The task force used the survey results to create a position paper outlining the value of academic global surgeons to AHCs. The survey had a 58% (n= 36) response rate. An academic global surgeon has a US medical school appointment, spends dedicated time in an LMIC, spends vacation time doing mission work, or works primarily in an LMIC. Most spend 1 to 3 months abroad annually, dedicating <25% effort to global surgery, including systems building, teaching, research, and clinical care. Most are university-employed and 65% report compensation is equivalent or greater than colleagues. Academic support includes administrative, protected time, funding. Most institutions do not use specific global surgery metrics to measure productivity. Barriers include funding, clinical responsibilities, and salary support. Academic global surgeons spend a modest amount of time abroad, require minimal financial support, and represent a low-cost investment in an under-recognized scholarship area. This position paper suggests measures of global surgery that could provide opportunities for AHCs and surgical departments to expand missions of service, education, and research and enhance institutional reputation while achieving societal impact.

The 'major' complications of cochlear implantation

The objective of the present study was to improve the selected surgical stages of cochlear implantation (CIP) taking into consideration the results of the analysis of the outcomes of re-operations. A total of 53 patients (4 adults and 49 children) were referred to our clinic for re-operations deemed to be required for the management the major complications following CI during the period from 2014 to 2017. Primary cochlear implantation was performed in other clinics. Re-operations were carried out at different time intervals after the primary surgical intervention under the guidance of a single experienced surgeon. The technical malfunction of the inner part of the implant prevailed among the causes behind the major complications of CI. It accounted for 47% of the total number of complications and required the replacement of the device. The next most frequent form of the complications (that accounted for 15% of all the cases) was the introduction of an active electrode into the cells of hypotympanum. The remaining complications occurred only in isolated cases. The detailed analysis of all the revealed complications was undertaken with the description of their causes and variants and the surgical strategy chosen for the management of each concrete patient. The decision about the necessity of either the removal or the substitution of the implant was taken on an individual basis. The successful outcome of the surgical treatment of all the operated patients with the major complications of cochlear implantation was achieved. The frequency and severity of the major complications of cochlear implantation are directly dependent on the patient's anatomical features, surgeon's qualifications, the quality of the implants, and lifestyle factors (e.g. head trauma, etc.). Cochlear implantation continues to be the only method for hearing rehabilitation in the patients suffering from severe sensorineural impairment of hearing. In the cases of cochlear implantation with the prospects of delayed re-implantation, leaving the active electrode in the scala tympani of the cochlea is a necessary measure to prevent synechiae.

The use of disposable skin staples for intestinal resection and anastomosis in 63 dogs: 2000 to 2014

To describe the use of disposable skin staples for intestinal resection and anastomosis in dogs and report associated dehiscence and mortality rates. Retrospective evaluation of medical records of dogs that underwent intestinal resection and anastomosis using disposable skin staples between 2000 and 2014. Data regarding patient signalment, indication for surgery, location of the resection and anastomosis, number of procedures performed, evidence of peritonitis at the time of surgery, surgeon qualifications, dehiscence, and mortality were obtained from the medical records. Mortality was defined as failure to survive beyond 10 days following resection and anastomosis. The overall mortality rate of patients undergoing intestinal resection and anastomosis was 12·7% (8/63). The most common indication for resection and anastomosis was neoplasia (20/63 [31·7%]), followed by foreign body removal (19/63 [30·2%]). The overall dehiscence rate was 4·8% (3/63). No difference in mortality associated with indication for surgery, whether multiple procedures were performed, surgeon qualifications, or evidence of peritonitis at the time of surgery was identified. In this retrospective study, the overall mortality and dehiscence rates using disposable skin staples were similar to previously reported outcomes following resection and anastomosis.

Choosing a cancer surgeon: analyzing factors in patient decision making using a best-worst scaling methodology.

Surgeon experience has been shown to influence outcomes for many types of cancer. The factors that patients consider when selecting a hospital or surgeon for cancer treatment remain poorly defined. All patients with a cancer diagnosis seeking treatment at a surgical clinic at Johns Hopkins Hospital were asked to participate. A survey utilizing a best-worst scaling methodology was constructed to elicit the importance of various factors when selecting a cancer surgeon. Attributes were grouped into four categories: surgeon reputation, surgeon qualifications, hospital-related factors, and nonclinical factors. Two hundred fourteen patients with a cancer diagnosis participated in the study (82.0% response rate). Patients placed the highest value on physician qualifications and hospital-related factors. Specifically, surgeon case-specific experience (coefficient 2.56, SE 0.06) and the receipt of specialized training by the surgeon (coefficient 2.32, SE 0.06) ranked highest (both P<0.001). Among hospital-related factors, hospital case-specific volume (coefficient 1.32, SE 0.06; P<0.001) was most important. The lowest rated factors were parking availability (coefficient -2.81, SE 0.06) and home-to-clinic distance (coefficient -2.12, SE 0.06) (both P<0.001). The majority of patients reported their ideal surgeon to have at least 6years of experience (n=143, 68.1%) and to have performed their specific procedure at least 50 times (n=156, 75.3%). Patients consider several factors when choosing a cancer surgeon. Surgeon qualifications and hospital-related factors appear to be most influential in their decision. Easier and more widespread dissemination of surgeon and hospital cancer data such as case volume may be useful for patients.

René Leriche and "Philosophy of Surgery" in the light of contemporary medical ethics.

Prof. Dr. René Leriche was a famous French surgeon who lived between 1879 and 1955. After working as a vascular surgeon in Lyon, he was appointed professor at the University of Strasbourg in 1924 and later the Paris Collége de France in 1937. Leriche had proposed vascular patches as the ideal treatment for obliterated vascular segments and advocated the necessity of sympathectomy in arterial diseases in the 1920s. He defined "Leriche Syndrome" in 1923 which is known by his name and which develops as a result of incomplete obstruction of the aortic bifurcation. René Leriche wrote a monograph entitled "La Chirurgie de la Douleur-Pain Surgery" in 1940 and he also became a pioneer in the sympathectomy procedure for pain treatment. René Leriche focused on topics that must be remembered again today, including surgery advanced into science, the physiological basis of surgery, research methods, as well as issues such as business technology, humanity in surgery, surgical essence and surgeon's qualifications in the book entitled "La Philosophie de la Chirurgie-Philosophy of Surgery" that he wrote in 1951. In this review, the issues that Prof. Dr. René Leriche addressed in middle of the 20(th) century were revised in the light of contemporary medical ethics.

Clinical Statement on the Requirements for Surgeon Certification for Implantation of Durable Ventricular Assist Devices (VADs)

Current Centers for Medicare and Medicaid (CMS) requirement for surgeon qualifications for implantation of durable, long-term ventricular assist devices (VADs) for destination therapy requires “placement of 10 ventricular assist devices in the last 36 months with current activity in the last 12 months and with volume requirement met by including artificial heart placements for no more than 50% of the total volume.”

Planning for Success: Desired Characteristics of Special Operations Surgeons, A Pilot Study

Selection criteria for Special Operations Forces (SOF) physicians are often unclear to potential candidates without prior SOF experience. To date, no published career resource exists to guide the careers of physicians interested in becoming a SOF surgeon. Using a survey tool, desirable characteristics and personal attributes were identified that can be used to inform candidate career decisions and better prepare them for a future position in Special Operations.A descriptive, cross-sectional survey instrument was developed and distributed to current Army SOF Command Surgeons for further distribution to subordinate surgeons. RESULTS were analyzed as a cohort and by subordinate command.Respondents consisted of current SOF Surgeons. Uniformly, the individual characteristics most strongly desired are professionalism, being a team player, and leadership. Possessing or obtaining Airborne and Flight Surgeon qualifications prior to consideration for a surgeon position was highly desired. Residency training within Family Medicine or Emergency Medicine constituted the vast majority of specialty preference.Understanding which characteristics and attributes are desirable to current surgeons and commanders can aid physicians interested in SOF surgeon positions. Using this study and future studies can guide career planning and foster the selection of ideally trained physicians who will operate at the tip of the spear. The views expressed are those of the author(s) and do not reflect the official policy of the Department of the Army, the Department of Defense or the U.S. Government.

Best Practice Updates for Surgical Care in Weight Loss Surgery

To update evidence-based best practice guidelines for surgical care in weight loss surgery (WLS). Systematic search of English-language literature on WLS in MEDLINE, EMBASE, and the Cochrane Library between April 2004 and May 2007. Use of key words to narrow the search for a selective review of abstracts, retrieval of full articles, and grading of evidence according to systems used in established evidence-based models. Evidence-based best practice recommendations from the most recent literature on surgical methods and technologies, risks and benefits, outcomes, and surgeon qualifications and credentialing. We identified >135 articles; the 65 most relevant were reviewed in detail. Regular updates of evidence-based recommendations for best practices in WLS are required to address rapid changes in surgical techniques and patient demographics. Key factors in patient safety include surgical risk factors, type of procedure, surgeon training, and facility certification.

Making Sense of Refractive Surgery in 2001: Why, When, for Whom, and by Whom?

Making Sense of Refractive Surgery in 2001: Why, When, for Whom, and by Whom?

The American Society For Bariatric Surgery (ASBS) Statement on Bariatric Surgeon Qualifications, October 12, 1997

The American Society For Bariatric Surgery (ASBS) Statement on Bariatric Surgeon Qualifications, October 12, 1997

The Cancun IFSO Statement on bariatric surgeon qualifications. International Federation for the Surgery of Obesity.

The Cancun IFSO Statement on bariatric surgeon qualifications. International Federation for the Surgery of Obesity.

Diagnostic Laparoscopy Under Local Anesthesia for Evaluation of Infertility

Diagnostic laparoscopy is routinely performed in outpatient departments. At Stanford University's Gyn/Ob Department Clinic, this procedure is performed with the client's active cooperation by using local anesthesia. In addition to the significant benefit of decreased risk of surgical anesthesia, outpatient surgery is more convenient and more economical for the client and the facility. The laparoscopic procedure is described in detail. The facilities, nursing responsibilities, surgeon's qualifications, and criteria for patient selection are included.

Professional Power and Professional Effectiveness: The Power of the Surgical Staff and the Quality of Surgical Care in Hospitals

In order to examine some of the determinants of professional effectiveness in professional organizations, a study was conducted relating the power of the surgical organization in hospitals to the quality of surgical care delivered. Data utilized were from approximately 8,000 patients treated by 500 surgeons in 15 short-term general hospitals in the United States. Several measures were employed to assess two aspects of power: (1) the power of the surgical staff and other major role groups within each hospital, and (2) the power of the surgical staff over individual surgeons. Quality of surgical care was measured by mortality and morbidity data, adjusted for differences among patients in pre-surgical condition. Additional variables were introduced to assess surgeon qualifications, hospital characteristics, and features other than power differences which might relate to outcome. Controlling for those variables which did significantly affect adjusted outcomes, regression analyses revealed that the extent of control exercised by the surgical staff over individual surgeons did relate to the quality of care as predicted. However, the power of the surgical staff relative to other groups did not relate significantly to care quality; rather, higher power by the hospital administration was the factor most strongly associated with quality of surgical care.