Who performs endocrine operations in the United States?

Brian D. Saunders, Reid M. Wainess, Justin B. Dimick, Gerard M. Doherty, Gilbert R. Upchurch, Paul G. Gauger, Herbert Chen, Ashok R. Shaha, Richard A. Hodin, Karen R. Borman, Clive S. Grant, Lawrence A. Danto

Research output: Contribution to journalArticle

98 Citations (Scopus)

Abstract

Background. Endocrine surgery is a discipline that is dedicated to high-quality care of patients with endocrine surgical disease. The relationship between its "identity" as a separate field and clinical practice patterns is not known. Methods. The National Inpatient Sample was searched by the International Classification of Diseases-9th revision-Clinical Modification codes for parathyroidectomy, thyroidectomy, and adrenalectomy for the years 1988 through 2000. The surgeons who performed these operations were profiled by 2 methods: Method A, by the percentage of the total primary International Classification of Diseases-9th revision-Clinical Modification procedure codes that were the selected endocrine procedures; method B, by absolute number of index endocrine procedures performed per year. Only patients with complete coding data for the surgeons were included. Results. In this sample, surgeons whose practice was comprised of 25% or less of these endocrine procedures performed 11,071 parathyroidectomies (78% of total), 46,210 thyroidectomies (82% of total), and 4209 adrenalectomies (94% of total). In contrast, surgeons whose practice was comprised of more than 75% of these endocrine procedures performed 769 parathyroidectomies (5% of total), 1560 thyroidectomies (3% of total), and 128 adrenalectomies (3% of total). Conclusion. If these data can be extrapolated to indicate generalized practice patterns, the majority of common operations for endocrine disease are performed by surgeons whose practice is not focused on endocrine surgery. However, much of this effect is due to the fact that non-endocrine surgeons far outnumber endocrine surgeons. This understanding of clinical practice patterns will be important to consider during future studies that seek to determine the relationship between surgeon volume and patient outcomes.

Original languageEnglish (US)
Pages (from-to)924-931
Number of pages8
JournalSurgery
Volume134
Issue number6
DOIs
StatePublished - Dec 2003

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Parathyroidectomy
Adrenalectomy
Thyroidectomy
Physicians' Practice Patterns
Endocrine System Diseases
International Classification of Diseases
Surgeons
Quality of Health Care
Inpatients

All Science Journal Classification (ASJC) codes

  • Surgery

Cite this

Saunders, B. D., Wainess, R. M., Dimick, J. B., Doherty, G. M., Upchurch, G. R., Gauger, P. G., ... Danto, L. A. (2003). Who performs endocrine operations in the United States? Surgery, 134(6), 924-931. https://doi.org/10.1016/S0039-6060(03)00420-3
Saunders, Brian D. ; Wainess, Reid M. ; Dimick, Justin B. ; Doherty, Gerard M. ; Upchurch, Gilbert R. ; Gauger, Paul G. ; Chen, Herbert ; Shaha, Ashok R. ; Hodin, Richard A. ; Borman, Karen R. ; Grant, Clive S. ; Danto, Lawrence A. / Who performs endocrine operations in the United States?. In: Surgery. 2003 ; Vol. 134, No. 6. pp. 924-931.
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title = "Who performs endocrine operations in the United States?",
abstract = "Background. Endocrine surgery is a discipline that is dedicated to high-quality care of patients with endocrine surgical disease. The relationship between its {"}identity{"} as a separate field and clinical practice patterns is not known. Methods. The National Inpatient Sample was searched by the International Classification of Diseases-9th revision-Clinical Modification codes for parathyroidectomy, thyroidectomy, and adrenalectomy for the years 1988 through 2000. The surgeons who performed these operations were profiled by 2 methods: Method A, by the percentage of the total primary International Classification of Diseases-9th revision-Clinical Modification procedure codes that were the selected endocrine procedures; method B, by absolute number of index endocrine procedures performed per year. Only patients with complete coding data for the surgeons were included. Results. In this sample, surgeons whose practice was comprised of 25{\%} or less of these endocrine procedures performed 11,071 parathyroidectomies (78{\%} of total), 46,210 thyroidectomies (82{\%} of total), and 4209 adrenalectomies (94{\%} of total). In contrast, surgeons whose practice was comprised of more than 75{\%} of these endocrine procedures performed 769 parathyroidectomies (5{\%} of total), 1560 thyroidectomies (3{\%} of total), and 128 adrenalectomies (3{\%} of total). Conclusion. If these data can be extrapolated to indicate generalized practice patterns, the majority of common operations for endocrine disease are performed by surgeons whose practice is not focused on endocrine surgery. However, much of this effect is due to the fact that non-endocrine surgeons far outnumber endocrine surgeons. This understanding of clinical practice patterns will be important to consider during future studies that seek to determine the relationship between surgeon volume and patient outcomes.",
author = "Saunders, {Brian D.} and Wainess, {Reid M.} and Dimick, {Justin B.} and Doherty, {Gerard M.} and Upchurch, {Gilbert R.} and Gauger, {Paul G.} and Herbert Chen and Shaha, {Ashok R.} and Hodin, {Richard A.} and Borman, {Karen R.} and Grant, {Clive S.} and Danto, {Lawrence A.}",
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Saunders, BD, Wainess, RM, Dimick, JB, Doherty, GM, Upchurch, GR, Gauger, PG, Chen, H, Shaha, AR, Hodin, RA, Borman, KR, Grant, CS & Danto, LA 2003, 'Who performs endocrine operations in the United States?', Surgery, vol. 134, no. 6, pp. 924-931. https://doi.org/10.1016/S0039-6060(03)00420-3

Who performs endocrine operations in the United States? / Saunders, Brian D.; Wainess, Reid M.; Dimick, Justin B.; Doherty, Gerard M.; Upchurch, Gilbert R.; Gauger, Paul G.; Chen, Herbert; Shaha, Ashok R.; Hodin, Richard A.; Borman, Karen R.; Grant, Clive S.; Danto, Lawrence A.

In: Surgery, Vol. 134, No. 6, 12.2003, p. 924-931.

Research output: Contribution to journalArticle

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T1 - Who performs endocrine operations in the United States?

AU - Saunders, Brian D.

AU - Wainess, Reid M.

AU - Dimick, Justin B.

AU - Doherty, Gerard M.

AU - Upchurch, Gilbert R.

AU - Gauger, Paul G.

AU - Chen, Herbert

AU - Shaha, Ashok R.

AU - Hodin, Richard A.

AU - Borman, Karen R.

AU - Grant, Clive S.

AU - Danto, Lawrence A.

PY - 2003/12

Y1 - 2003/12

N2 - Background. Endocrine surgery is a discipline that is dedicated to high-quality care of patients with endocrine surgical disease. The relationship between its "identity" as a separate field and clinical practice patterns is not known. Methods. The National Inpatient Sample was searched by the International Classification of Diseases-9th revision-Clinical Modification codes for parathyroidectomy, thyroidectomy, and adrenalectomy for the years 1988 through 2000. The surgeons who performed these operations were profiled by 2 methods: Method A, by the percentage of the total primary International Classification of Diseases-9th revision-Clinical Modification procedure codes that were the selected endocrine procedures; method B, by absolute number of index endocrine procedures performed per year. Only patients with complete coding data for the surgeons were included. Results. In this sample, surgeons whose practice was comprised of 25% or less of these endocrine procedures performed 11,071 parathyroidectomies (78% of total), 46,210 thyroidectomies (82% of total), and 4209 adrenalectomies (94% of total). In contrast, surgeons whose practice was comprised of more than 75% of these endocrine procedures performed 769 parathyroidectomies (5% of total), 1560 thyroidectomies (3% of total), and 128 adrenalectomies (3% of total). Conclusion. If these data can be extrapolated to indicate generalized practice patterns, the majority of common operations for endocrine disease are performed by surgeons whose practice is not focused on endocrine surgery. However, much of this effect is due to the fact that non-endocrine surgeons far outnumber endocrine surgeons. This understanding of clinical practice patterns will be important to consider during future studies that seek to determine the relationship between surgeon volume and patient outcomes.

AB - Background. Endocrine surgery is a discipline that is dedicated to high-quality care of patients with endocrine surgical disease. The relationship between its "identity" as a separate field and clinical practice patterns is not known. Methods. The National Inpatient Sample was searched by the International Classification of Diseases-9th revision-Clinical Modification codes for parathyroidectomy, thyroidectomy, and adrenalectomy for the years 1988 through 2000. The surgeons who performed these operations were profiled by 2 methods: Method A, by the percentage of the total primary International Classification of Diseases-9th revision-Clinical Modification procedure codes that were the selected endocrine procedures; method B, by absolute number of index endocrine procedures performed per year. Only patients with complete coding data for the surgeons were included. Results. In this sample, surgeons whose practice was comprised of 25% or less of these endocrine procedures performed 11,071 parathyroidectomies (78% of total), 46,210 thyroidectomies (82% of total), and 4209 adrenalectomies (94% of total). In contrast, surgeons whose practice was comprised of more than 75% of these endocrine procedures performed 769 parathyroidectomies (5% of total), 1560 thyroidectomies (3% of total), and 128 adrenalectomies (3% of total). Conclusion. If these data can be extrapolated to indicate generalized practice patterns, the majority of common operations for endocrine disease are performed by surgeons whose practice is not focused on endocrine surgery. However, much of this effect is due to the fact that non-endocrine surgeons far outnumber endocrine surgeons. This understanding of clinical practice patterns will be important to consider during future studies that seek to determine the relationship between surgeon volume and patient outcomes.

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Saunders BD, Wainess RM, Dimick JB, Doherty GM, Upchurch GR, Gauger PG et al. Who performs endocrine operations in the United States? Surgery. 2003 Dec;134(6):924-931. https://doi.org/10.1016/S0039-6060(03)00420-3