Surgeons and Surgical Trainees Underestimate the Total Charges and Reimbursements Associated With Commonly Performed General Surgery Procedures✰.

Abstract:

INTRODUCTION:Surgical care contributes significantly to the fiscal challenges facing the US health care system. Multiple studies have demonstrated surgeons' lack of awareness of the costs associated with individual portions of surgical care, namely operating room supplies. We sought to assess surgeon and trainee awareness of the comprehensive charges and reimbursements associated with procedures they perform. METHODS:We administered a voluntary anonymous survey to attending surgeons, general surgery residents, and fourth-year medical students who applied to general surgery residencies. We compared charge and reimbursement estimates for laparoscopic cholecystectomy and open inguinal hernia repair to the actual values. Additionally, we assessed the importance placed on the financial aspects of surgical care. RESULTS:We had an overall response rate of 94% (n = 45). A majority of attendings, residents, and medical students underestimated charges and reimbursements for open inguinal hernia repair and laparoscopic cholecystectomy. There was no significant difference in the accuracy of charge or reimbursement estimates between attendings, residents, and students for herniorrhaphy or cholecystectomy (Charge: hernia p = 0.08, cholecystectomy p = 0.30; Reimbursement: hernia p = 0.47, cholecystectomy p = 0.89). Years of training as an attending or resident did not predict accuracy of charge or reimbursement estimates for hernia repair or cholecystectomy (p > 0.3 for all regressions). The median (interquartile range) charge estimate for inguinal hernia repair was -$5914 (-$7914 to -$2914) from the actual charge, 45.8% of the true value, and the median reimbursement estimate was -$4519 (-$5369 to -$1218) from actual reimbursement, 27.3% of the true value. The median charge estimate for cholecystectomy was -$5734 (-$8733 to +$1266) from the actual charge, 58.3% of the true value, and the median reimbursement estimate was -$4847 (-$6847 to +$153) from actual reimbursement, 38.2% of the true value. CONCLUSIONS:Surgeons and their trainees underestimate the charges and reimbursements associated with commonly performed procedures.

journal_name

J Surg Educ

authors

Paine AN,Krompf BL,Osler TM,Hebert JC

doi

10.1016/j.jsurg.2018.11.001

subject

Has Abstract

pub_date

2019-01-01 00:00:00

pages

802-807

issue

3

eissn

1931-7204

issn

1878-7452

pii

S1931-7204(18)30454-9

journal_volume

76

pub_type

杂志文章
  • Impact of fellowship training on research productivity in academic ophthalmology.

    abstract:OBJECTIVES:To assess whether scholarly impact of academic ophthalmologists, as measured using the h-index, is affected by fellowship training status and to further characterize differences in productivity among the various subspecialties and by departmental rank. DESIGN:A descriptive and correlational design was used....

    journal_title:Journal of surgical education

    pub_type: 杂志文章,多中心研究

    doi:10.1016/j.jsurg.2014.10.010

    authors: Huang G,Fang CH,Lopez SA,Bhagat N,Langer PD,Eloy JA

    更新日期:2015-05-01 00:00:00

  • General surgery vs fellowship: the role of the Independent Academic Medical Center.

    abstract:OBJECTIVES:To compare career choices of residency graduates from Independent Academic Medical Center (IAMC) and University Academic Medical Center (UAMC) programs and evaluate program directors' perceptions of residents' motivations for pursuing general surgery or fellowships. DESIGN:From May to August 2011, an electr...

    journal_title:Journal of surgical education

    pub_type: 杂志文章

    doi:10.1016/j.jsurg.2012.05.006

    authors: Adra SW,Trickey AW,Crosby ME,Kurtzman SH,Friedell ML,Reines HD

    更新日期:2012-11-01 00:00:00

  • Barriers to Completion of Research Projects Among Orthopaedic Trainees.

    abstract:INTRODUCTION & AIM:It is a requirement of the Australian Orthopaedic Association (AOA) training program that surgical education training (SET) trainees demonstrate competency in clinical or basic science research as part of their teaching curriculum. The aim of this study is to identify barriers in completing research ...

    journal_title:Journal of surgical education

    pub_type: 杂志文章

    doi:10.1016/j.jsurg.2018.04.008

    authors: Carter S,Liew S,Brown G,Moaveni AK

    更新日期:2018-11-01 00:00:00

  • Vessel Ligation Fundamentals: A Comparison of Technical Evaluations by Crowdsourced Nonclinical Personnel and Surgical Faculty.

    abstract:BACKGROUND:Evaluation of fundamental surgical skills is invaluable to the training of medical students and junior residents. This study assessed the effectiveness of crowdsourcing nonmedical personnel to evaluate technical proficiency at simulated vessel ligation. STUDY DESIGN:Fifteen videos were captured of participa...

    journal_title:Journal of surgical education

    pub_type: 杂志文章

    doi:10.1016/j.jsurg.2017.09.030

    authors: Hu Y,Jiang B,Kim H,Schroen AT,Smith PW,Rasmussen SK

    更新日期:2018-01-01 00:00:00

  • The Case for Capping Residency Interviews.

    abstract:OBJECTIVE:To determine 2020 residency cycle application practices and to model potential consequences in the 2021 cycle if (1) applicants scheduled an uncapped number of interviews; (2) applicants were capped to schedule 12 interviews; (3) residency programs kept their number of interview offers unchanged; and (4) prog...

    journal_title:Journal of surgical education

    pub_type: 杂志文章

    doi:10.1016/j.jsurg.2020.08.033

    authors: Morgan HK,Winkel AF,Standiford T,Muñoz R,Strand EA,Marzano DA,Ogburn T,Major CA,Cox S,Hammoud MM

    更新日期:2020-09-14 00:00:00

  • Objective Assessment of the Entrustable Professional Activity Handover in Undergraduate and Postgraduate Surgical Learners.

    abstract:OBJECTIVE:This study used a virtual patient simulation (VPS) to quantifiably and objectively assess undergraduate (UG) to postgraduate (PG) medical learners' acquisition of the entrustable professional activity (EPA) "handover," focusing particularly on the transition to residency. This EPA is critical because it is pa...

    journal_title:Journal of surgical education

    pub_type: 杂志文章

    doi:10.1016/j.jsurg.2019.03.008

    authors: Posel N,Hoover ML,Bergman S,Grushka J,Rosenzveig A,Fleiszer D

    更新日期:2019-01-01 00:00:00

  • Examination of Skill Acquisition and Grader Bias in a Distal Radius Fracture Fixation Model.

    abstract:OBJECTIVES:Primary: Assess the ability of faculty graders to predict the objectively measured strength of distal radius fracture fixation. Secondary: Compare resident skill variation and retention related to other knowable training data. DESIGN:Residents were allowed 60 minutes to stabilize a standardized distal radiu...

    journal_title:Journal of surgical education

    pub_type: 杂志文章

    doi:10.1016/j.jsurg.2018.01.019

    authors: Putnam MD,Adams JE,Lender P,Van Heest AE,Shanedling JR,Nuckley DJ,Bechtold JE

    更新日期:2018-01-01 00:00:00

  • Teaching subcuticular suturing to medical students: video versus expert instructor feedback.

    abstract:OBJECTIVE:Given limitations in surgical educational resources, more efficient teaching methods are needed. We sought to evaluate 3 strategies for improving skills in subcuticular suturing-practice with an instructional video, practice with expert instructor supervision, and independent practice. DESIGN:Fifty-eight med...

    journal_title:Journal of surgical education

    pub_type: 杂志文章,随机对照试验

    doi:10.1016/j.jsurg.2011.04.006

    authors: Shippey SH,Chen TL,Chou B,Knoepp LR,Bowen CW,Handa VL

    更新日期:2011-09-01 00:00:00

  • An experience in surgical anatomy to provide first-year medical students with an early exposure to general surgery: a pilot study.

    abstract:INTRODUCTION:The level of interest expressed by medical students toward the field of general surgery has decreased. The aims of this study were to (1) describe an educational scheme in surgical anatomy that increases interaction between practicing surgeons and first-year medical students and (2) garner feedback and opi...

    journal_title:Journal of surgical education

    pub_type: 杂志文章

    doi:10.1016/j.jsurg.2009.04.005

    authors: Are C,Stoddard HA,Northam LC,Thompson JS,Todd GL

    更新日期:2009-07-01 00:00:00

  • Entrustable Professional Activities in General Surgery: Trends in Resident Self-Assessment.

    abstract:OBJECTIVE:Effective self-assessment is a cornerstone of lifelong professional development; however, evidence suggests physicians have a limited ability to self-assess. Novel strategies to improve the accuracy of learner self-assessment are needed. Our institution's surgical entrustable professional activity (EPA) imple...

    journal_title:Journal of surgical education

    pub_type: 杂志文章

    doi:10.1016/j.jsurg.2020.05.005

    authors: Stahl CC,Jung SA,Rosser AA,Kraut AS,Schnapp BH,Westergaard M,Hamedani AG,Minter RM,Greenberg JA

    更新日期:2020-01-01 00:00:00

  • Characterizing information decay in patient handoffs.

    abstract:OBJECTIVE:The purpose of this study was to analyze the decay of information with multiple sequential patient handoff reports given by third-year medical students who have not had standardized patient handoff training. METHODS:We examine the information decay of quantitative parameters included in 2 different simulated...

    journal_title:Journal of surgical education

    pub_type: 杂志文章

    doi:10.1016/j.jsurg.2013.12.002

    authors: Jensen AM,Sanders C,Doty J,Higbee D,Rawlings AL

    更新日期:2014-07-01 00:00:00

  • Evaluation of Changes in Quality Improvement Knowledge Following a Formal Educational Curriculum Within a Statewide Learning Collaborative.

    abstract:OBJECTIVE:Our objectives were to (1) develop a curriculum based upon participants' needs, (2) evaluate baseline QI knowledge of the Illinois Surgical Quality Improvement Collaborative (ISQIC) members, and (3) evaluate the effectiveness of the educational curriculum. DESIGN:The Surgeon Champion (SC), Surgical Clinical ...

    journal_title:Journal of surgical education

    pub_type: 杂志文章

    doi:10.1016/j.jsurg.2020.04.018

    authors: Berger ER,Kreutzer L,Halverson A,Yang AD,Reinhart S,Leary KJO,Williams MV,Bilimoria KY,Johnson JK,ISQIC Advisory Committee.

    更新日期:2020-01-01 00:00:00

  • The assessment of emotional intelligence among candidates interviewing for general surgery residency.

    abstract:BACKGROUND:There is an increasing demand for physicians to possess strong personal and social qualities embodied in the concept of emotional intelligence (EI). However, the residency selection process emphasizes mainly academic accomplishments. In this system, the faculty interview is the primary means of evaluating th...

    journal_title:Journal of surgical education

    pub_type: 杂志文章

    doi:10.1016/j.jsurg.2013.03.010

    authors: Lin DT,Kannappan A,Lau JN

    更新日期:2013-07-01 00:00:00

  • Comparison of surgical residency applicants from U.S. medical schools with U.S.-born and foreign-born international medical school graduates.

    abstract:OBJECTIVE:Compare characteristics of U.S. medical school graduates with U.S.-born and foreign-born international medical school (IMG) graduates. DESIGN:Retrospective analysis. SETTING:East Carolina University, a tertiary care teaching hospital. PARTICIPANTS:Demographic data, United States Medical Licensing Examinati...

    journal_title:Journal of surgical education

    pub_type: 杂志文章

    doi:10.1016/j.jsurg.2008.05.002

    authors: Schenarts PJ,Love KM,Agle SC,Haisch CE

    更新日期:2008-11-01 00:00:00

  • Educational debt of physicians-in-training: determining the level of interest in a loan repayment program for service in a medically underserved area.

    abstract:PURPOSE:The amount of financial debt incurred by Texas medical students and residents during training was examined as well as the impact of this debt on these trainees' career choices. METHOD:An invitation to participate was sent in a Web-based survey to medical students and residents at 6 university programs in Texas...

    journal_title:Journal of surgical education

    pub_type: 杂志文章

    doi:10.1016/j.jsurg.2008.09.003

    authors: Price MA,Cohn SM,Love J,Dent DL,Esterl R

    更新日期:2009-01-01 00:00:00

  • A Novel Neurosurgery Referral Course: Feasibility, Validation, and Inferences for Patient Care.

    abstract:OBJECTIVE:The speciality of neurosurgery is under-represented in the majority of medical school curriculums, and those rotating within this specialty tend to be those with career aspirations within this field. Consequently, few emergency medicine trainees are exposed to this specialty. The aim of this educational proje...

    journal_title:Journal of surgical education

    pub_type: 杂志文章

    doi:10.1016/j.jsurg.2020.04.017

    authors: Pradini-Santos L,Craven CL,Usher I,Mullins S,D'Antona L,Al-Ahmad S,Abuhusain H,Sayal PP

    更新日期:2020-01-01 00:00:00

  • Resident Participation as Co-Surgeon Does Not Adversely Impact Patient Outcomes in Pancreatic Surgery.

    abstract:OBJECTIVE:In academic settings, surgical residents often serve as co-surgeon in complex operations such as pancreatic resections. These operations are typically performed by fellowship-trained primary surgeons with extensive experience in the field. Our study aimed to evaluate how the participation of general surgery r...

    journal_title:Journal of surgical education

    pub_type: 杂志文章

    doi:10.1016/j.jsurg.2020.04.006

    authors: Gabel SA,Morrison ZD,Sharma R,Wernberg JA

    更新日期:2020-01-01 00:00:00

  • Can Rural Minimally Invasive Surgery Fellowships Provide Operative Experience Similar to Urban Programs?

    abstract:OBJECTIVE:Operative experience in rural fellowship programs is largely unknown. The 2 of the most rural minimally invasive surgery (MIS)/bariatric fellowships are located in the upper Midwest. We hypothesized that these 2 programs would offer a similar operative experience to other U.S. programs in more urban locations...

    journal_title:Journal of surgical education

    pub_type: 杂志文章

    doi:10.1016/j.jsurg.2016.04.012

    authors: Ryan JP,Borgert AJ,Kallies KJ,Carlson LM,McCollister H,Severson PA,Kothari SN

    更新日期:2016-09-01 00:00:00

  • National Incidence of Medication Error in Surgical Patients Before and After Accreditation Council for Graduate Medical Education Duty-Hour Reform.

    abstract:OBJECTIVE:The Accreditation Council for Graduate Medical Education (ACGME) established duty-hour regulations for accredited residency programs on July 1, 2003. It is unclear what changes occurred in the national incidence of medication errors in surgical patients before and after ACGME regulations. DESIGN:Patient and ...

    journal_title:Journal of surgical education

    pub_type: 杂志文章

    doi:10.1016/j.jsurg.2015.05.013

    authors: Vadera S,Griffith SD,Rosenbaum BP,Chan AY,Thompson NR,Kshettry VR,Kelly ML,Weil RJ,Bingaman W,Jehi L

    更新日期:2015-11-01 00:00:00

  • Surgical Resident Radiation Knowledge, Attitudes, Practices, and Exposures.

    abstract:OBJECTIVE:To investigate the level of ionizing radiation exposure among surgical residents and to evaluate resident knowledge, attitudes, and practices regarding exposures. DESIGN:An observational study was conducted using radiation exposure data for surgical residents who wore film badge dosimeters. A cross-sectional...

    journal_title:Journal of surgical education

    pub_type: 杂志文章

    doi:10.1016/j.jsurg.2016.05.002

    authors: Sidwell RA,Smith HL,Halsey JP,McFarlane MJ

    更新日期:2016-01-01 00:00:00

  • A randomized controlled study to establish the effect of articulating instruments on performance in single-incision laparoscopic surgery.

    abstract:OBJECTIVE:In single-incision laparoscopic surgery (SILS), operating through 1 incision presents ergonomic challenges. No consensus exists on whether articulating instruments (ARTs) may help. This study evaluated their effect on simulated SILS, hypothesizing that they would affect performance and workload. DESIGN:Surge...

    journal_title:Journal of surgical education

    pub_type: 杂志文章,随机对照试验

    doi:10.1016/j.jsurg.2014.08.004

    authors: Corker HP,Singh P,Sodergren MH,Balaji S,Kwasnicki RM,Darzi AW,Paraskeva P

    更新日期:2015-01-01 00:00:00

  • A Sensitivity Analysis and Opportunity Cost Evaluation of the Surgical Council on Resident Education Curriculum.

    abstract:OBJECTIVE:The study purpose is to evaluate the Surgical Council on Resident Education (SCORE) Curriculum regarding American Board of Surgery Qualifying Examination (ABS QE) outcomes. The goal is to perform effect size analyses, sensitivity analyses, and sample size analyses with opportunity cost estimates required to f...

    journal_title:Journal of surgical education

    pub_type: 杂志文章

    doi:10.1016/j.jsurg.2015.09.009

    authors: Falcone JL,Feinn RS

    更新日期:2016-01-01 00:00:00

  • Trauma and Orthopedic Surgery Curriculum Concordance: An Operative Learning Curve Trajectory Perspective.

    abstract:INTRODUCTION:Certification of completion of training in Trauma and Orthopedic (T&O) surgery in the UK requires the demonstration of operative competence in 12 index procedures, achieved through attaining a level 4 consultant-validated procedure-based assessment (PBA). The aim of this study was to evaluate the trajector...

    journal_title:Journal of surgical education

    pub_type: 杂志文章

    doi:10.1016/j.jsurg.2019.05.009

    authors: Hopkins L,Robinson DBT,Brown C,Egan R,Iorwerth A,Holt M,Lewis WG

    更新日期:2019-01-01 00:00:00

  • The Independent Plastic Surgery Match (2010-2018): Applicant and Program Trends, Predictors of a Successful Match, and Future Directions.

    abstract:OBJECTIVES:Changes were made to the independent plastic surgery residency in 2009 to 2010 that included full prerequisite training and increased from 2 to 3 years of independent residency. The authors sought to determine subsequent match trends and predictors of a successful match. METHODS:With American Council of Aca...

    journal_title:Journal of surgical education

    pub_type: 杂志文章

    doi:10.1016/j.jsurg.2019.07.018

    authors: Azoury SC,Kozak GM,Stranix JT,Colen DL,Piwnica-Worms W,Fosnot J,Serletti JM,Kovach SJ

    更新日期:2020-01-01 00:00:00

  • Compassion Fatigue in Surgical Trainees.

    abstract:OBJECTIVE:Compassion fatigue (CF) is the profound sense of emotional exhaustion that care providers can experience as the result of helping others in distress. CF can contribute to burnout (BO), depression, and stress-related illness. While surgeons and surgical trainees may be at high risk for developing CF, it has no...

    journal_title:Journal of surgical education

    pub_type: 杂志文章

    doi:10.1016/j.jsurg.2019.03.012

    authors: Seemann NM,Karanicolas PJ,Guttman MP,Nathens AB,Tien HC,Ellis J,Zaretsky A,Gotlib Conn L

    更新日期:2019-01-01 00:00:00

  • The effect of problem-based learning with cooperative-learning strategies in surgery clerkships.

    abstract:BACKGROUND:Cooperative learning is used often as part of the problem-based learning (PBL) process. But PBL does not demand that students work together until all individuals master the material or share the rewards for their work together. OBJECTIVE:A cooperative learning and assessment structure was introduced in a PB...

    journal_title:Journal of surgical education

    pub_type: 杂志文章

    doi:10.1016/j.jsurg.2011.07.010

    authors: Turan S,Konan A,Kılıç YA,Özvarış ŞB,Sayek I

    更新日期:2012-03-01 00:00:00

  • What do surgical nurses know about surgical residents?

    abstract:OBJECTIVE:A fundamental premise of establishing collaborative relationships between residents and nurses is a basic understanding of the attributes of each group. The intent of this study was to determine what surgical nurses know about surgical residents. DESIGN:A piloted survey tool was administered to a cross-secti...

    journal_title:Journal of surgical education

    pub_type: 杂志文章

    doi:10.1016/j.jsurg.2009.08.001

    authors: Schlitzkus LL,Agle SC,McNally MM,Schenarts KD,Schenarts PJ

    更新日期:2009-11-01 00:00:00

  • Fate of abstracts presented at the 2009 American Transplant Congress.

    abstract:INTRODUCTION:Oral and poster presentations at major meetings serve to rapidly present and share study results with the scientific community. On the other hand, full-text publication of abstracts in peer-reviewed journals provides dissemination of knowledge. The purpose of this study was to evaluate the publication rate...

    journal_title:Journal of surgical education

    pub_type: 杂志文章

    doi:10.1016/j.jsurg.2014.02.002

    authors: Durinka JB,Chang PN,Ortiz J

    更新日期:2014-09-01 00:00:00

  • Surgical Residency Recruitment-Opportunities for Improvement.

    abstract:INTRODUCTION:The Association of Program Directors in Surgery convened a panel during Surgical Education Week 2016 to discuss the current state of the general surgery residency application process and to review alternative ways to evaluate the suitability of each applicant to a residency program. METHODS/RESULTS:Over 4...

    journal_title:Journal of surgical education

    pub_type: 杂志文章,评审

    doi:10.1016/j.jsurg.2016.09.005

    authors: Joshi ART,Vargo D,Mathis A,Love JN,Dhir T,Termuhlen PM

    更新日期:2016-01-01 00:00:00

  • Multilevel Quality Improvement Teams: An Alternative Approach for Surgical Academic Training Programs to Meet ACGME Core Competency Milestones.

    abstract:BACKGROUND:Quality improvement (QI) activities are an integral part of residency training. We started the process to implement team-based, multilevel QI project streams within our academic surgical residency by studying resident perceptions. OBJECTIVE:Our residency carried out 6 QI projects in line with the American C...

    journal_title:Journal of surgical education

    pub_type: 杂志文章

    doi:10.1016/j.jsurg.2018.10.006

    authors: Hajjar-Nejad MJ,Kubicki N,Morales D,Kavic SM

    更新日期:2019-01-01 00:00:00