Abstract:
BACKGROUND:In academic institutions, residents make substantial contributions to clinical productivity. However, billing cannot be generated unless there is direct attending physician supervision of these services. The purpose of this study was to quantify clinical services provided by residents at a large academic medical center. METHODS:The authors performed a review of all consultations to the plastic surgery service between January 1 and December 31, 2014. Documentation was reviewed and hypothetical billing for services was generated using American Medical Association Current Procedural Terminology and evaluation and management codes. RESULTS:A total of 2367 consultations were reviewed during the 1-year study period. Residents provided services under indirect supervision for the majority of consultations [n = 1940 (81.9 percent)]. If these services had been billed, evaluation and management would have resulted in 6970 physician work relative value units. More than half of the encounters (52.0 percent) involved at least one procedure, resulting in an additional 3316 work relative value units from 1339 Current Procedural Terminology codes. Using a conservative estimate (2014 Medicare reimbursement rates), charges from these services would total $368,496. CONCLUSIONS:The plastic surgery consultation service is a potential source of uncaptured revenue for training programs using indirect supervision of residents. Greater than 10,000 work relative value units could have been generated from resident clinical services, which is considerably more than the national average productivity of a full-time, academic plastic surgeon. Capturing a portion of this revenue stream could improve the fiscal balance of training programs and improve the cost-effective use of resident productivity.
journal_name
Plast Reconstr Surgjournal_title
Plastic and reconstructive surgeryauthors
Drolet BC,Tandon VJ,Sargent R,Loor K,Schmidt ST,Liu PYdoi
10.1097/PRS.0000000000002485subject
Has Abstractpub_date
2016-09-01 00:00:00pages
539e-542eissue
3eissn
0032-1052issn
1529-4242pii
00006534-201609000-00037journal_volume
138pub_type
杂志文章abstract:LEARNING OBJECTIVES:After studying this article, the participant should be able to: 1. Describe the differential diagnosis of breast tumors in adolescent girls. 2. Compare and contrast surgical options for the management of adolescent breast tumors. 3. Recognize the utility of a reduction mammaplasty technique when res...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章,评审
doi:10.1097/01.prs.0000264396.03452.62
更新日期:2007-07-01 00:00:00
abstract::Pectus excavatum is the most common deformity of the chest wall. The overwhelming majority of patients with pectus excavatum have no physiologic compromise. Adolescents beyond their growth spurt and adults who are asymptomatic are best served by placement of a silicone implant to correct the chest-wall defect. We have...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-198407000-00007
更新日期:1984-07-01 00:00:00
abstract:BACKGROUND:Although the introduction of acellular dermal matrices is considered one of the most important advancements in alloplastic breast reconstruction, costs and local policy limit their use in Italy. The purpose of this study was to assess short-term outcomes following Surgimesh-PET-based breast reconstruction. ...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/PRS.0000000000002180
更新日期:2016-06-01 00:00:00
abstract::Twenty-three children with Down's syndrome, aged between 3.7 and 17.5 years, underwent partial glossectomy for improvement of cosmetic appearance. Improved speech was also expected. Preoperative and postoperative audiotaped samples of spoken words and connected speech on a standardized articulation test were rated by ...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-198701000-00007
更新日期:1987-01-01 00:00:00
abstract::Many patients of rhytidectomy age have had previous rhinoplasty or nasal injury and have dorsal irregularities or saddle-nose deformities. SMAS tissue ordinarily discarded at rhytidectomy may be used for nasal dorsal augmentation and padding. Six patients undergoing rhytidectomy who also had prior nasal surgery or def...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-199605000-00025
更新日期:1996-05-01 00:00:00
abstract:BACKGROUND:Free abdominal flaps are the first option in autologous breast reconstruction using the multidetector-row computed tomographic angiography for mapping the abdominal perforators. The authors aim to evaluate the impact of using a preoperative design for shaping the new breast symmetrical to the contralateral b...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/01.prs.0000436848.02033.2e
更新日期:2014-02-01 00:00:00
abstract::We have found that to expand the diameter of the smaller vessel by a fish-mouth incision is useful in performing microvascular end-to-end and end-to-side anastomosis, with marked discrepancy in size. ...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-198004000-00019
更新日期:1980-04-01 00:00:00
abstract:BACKGROUND:Although maxillary distraction osteogenesis has been used for early treatment of midfacial hypoplasia, the inevitable osteotomies are still a complicated and invasive procedure for growing patients. Based on the bone-borne trans-sutural distraction osteogenesis, novel improvements to the approach were made t...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/PRS.0000000000001375
更新日期:2015-07-01 00:00:00
abstract:LEARNING OBJECTIVES:After studying this article, the participant should be able to: 1. Have a clear understanding of the evolution of concepts of velopharyngeal dysfunction, especially as it relates to patients with a cleft palate. 2. Explain the subjective and objective evaluation of speech in children with velopharyn...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章,评审
doi:10.1097/PRS.0000000000003335
更新日期:2017-06-01 00:00:00
abstract::Three-dimensional measurement and characterization of facial surface anatomy are fundamental to the objective analysis of facial deformity. However, existing clinical tools are inadequate. Recent innovations in laser scanning technology provide a potentially useful technique for accurate three-dimensional documentatio...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-199608000-00004
更新日期:1996-08-01 00:00:00
abstract::In a rat model designed to simulate clinical angiography, preoperative angiography had no effect on free-flap survival. Only when a large dose of RCM was delivered directly into a surgically isolated circulation did significant free-flap loss ensue. ...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-198108000-00013
更新日期:1981-08-01 00:00:00
abstract::The authors tested the hypothesis that certain maneuvers (neck flexion/extension and head protrusion/retrusion) alter the appearance of the submental area, jawline, and melolabial groove. They used a questionnaire survey of 20 naïve judges who assessed a standardized photograph album of three subjects. The subjects' f...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/01.prs.0000127791.31526.e2
更新日期:2004-07-01 00:00:00
abstract::Xeroradiography can demonstrate many non-metallic foreign bodies that do not show by conventional radiography techniques. Two examples are shown. ...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:
更新日期:1977-09-01 00:00:00
abstract::Marked improvement in the aesthetic appearance of scars and skin grafts of the hair-bearing facial areas of male patients can be achieved by camouflage with punctate tattooing. The technique is easy and simple to learn. The procedure is performed under local anesthesia and on an outpatient basis. ...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-199308000-00027
更新日期:1993-08-01 00:00:00
abstract::Although local anesthesia will, and should, continue to be the principal method of anesthesia for most face lift operations, we believe that general endotracheal anesthesia, supplemented by local anesthesia with epinephrine, offers significant advantages in a selected group of patients. We review 100 consecutive rhyti...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-197711000-00012
更新日期:1977-11-01 00:00:00
abstract:BACKGROUND:Soft-tissue reconstruction following vulvar cancer resection is a difficult challenge because of the functional, locational, and cosmetic importance of this region. Although numerous flaps have been designed for vulvar reconstruction, each has its disadvantages. METHODS:The authors introduce the gluteal fol...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/01.prs.0000227683.47836.28
更新日期:2006-08-01 00:00:00
abstract::In 1964, I started using vertical mammaplasty without a submammary scar for all breast reductions. This technique was based on the following principles: a central wedge resection, an upper pedicle for the areola, no undermining, and a vertical scar to finish off. Because of the drawings, there was a pitfall: In large ...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-199602000-00015
更新日期:1996-02-01 00:00:00
abstract::Some new variations are described for partial and total ear reconstructions, eyebrow reconstructions, and sideburn reconstructions in burned patients. ...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:
更新日期:1975-03-01 00:00:00
abstract::The purpose of this study was to define the role of reconstruction plates as bone replacement in oromandibular reconstruction. From 1987 through 1991, 71 consecutive oral cancer patients underwent composite resection and reconstruction and were entered into one of two studies. In the first study of 31 patients, 15 und...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-199505000-00010
更新日期:1995-05-01 00:00:00
abstract::The mechanisms involved in normal cranial suture development and fusion as well as in the pathophysiology of craniosyostosis are not well understood. The purpose of this study was to investigate the expression of several cytokines--transforming growth factor-beta-1 (TGF-beta1), basic fibroblast growth factor (bFGF), a...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-199805000-00001
更新日期:1998-05-01 00:00:00
abstract::The purpose of this article is to present the authors' experience with the use of porous polyethylene ultrathin sheets for orbital floor reconstruction. Thirty-two patients with orbital floor fractures were treated with porous polyethylene ultrathin sheets. Sixteen cases corresponded to orbitozygomatic fractures, 11 c...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-200203000-00007
更新日期:2002-03-01 00:00:00
abstract:BACKGROUND:The latissimus dorsi myocutaneous flap is frequently used for total breast reconstruction; however, few reports have been available regarding clinical outcome following conservative breast surgery. The aim of this study was to perform a retrospective review on 48 patients undergoing immediate latissimus dors...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/01.prs.0000176251.15140.36
更新日期:2005-09-01 00:00:00
abstract::Analysis of intermediate- and long-term results of surgical treatment of metopic synostosis is lacking. We therefore retrospectively studied 23 patients with metopic synostosis (14 males, 9 females) who have been followed from 3 months to 8.1 years (mean 42.5 months) after operation. Age at first operation ranged from...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:
更新日期:1994-11-01 00:00:00
abstract::Dermabrasion debridement is presented as another method for tangential excision of "deep dermal" burns, with immediate or early skin grafting. The advantages in selected cases seem to be: (1) a more rapid healing; (2) a more stable end result, because dermis is present; (3) prevents spontaneous healing with unstable e...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-197707000-00009
更新日期:1977-07-01 00:00:00
abstract:BACKGROUND:Bariatric surgery for morbid obesity results in massive weight loss and improvement of health and quality of life. A downside of the major weight loss is the excess of overstretched skin, which may influence the patient's quality of life by causing functional and aesthetic problems. The purpose of the curren...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/PRS.0b013e318267d51d
更新日期:2012-11-01 00:00:00
abstract:BACKGROUND:The nasolabial angle is the angle between the line drawn through the midpoint of the nostril aperture and a line drawn perpendicular to the Frankfort horizontal plane while intersecting subnasale. Previous analysis by the authors' department yielded closer ranges between men and women of 96 and 98 degrees, r...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/PRS.0b013e3182958b40
更新日期:2013-08-01 00:00:00
abstract::Grafted fat has many attributes of an ideal filler, but the results, like those of any procedure, are technique dependent. Fat grafting remains shrouded in the stigma of variable results experienced by most plastic surgeons when they first graft fat. However, many who originally reported failure eventually report succ...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/01.prs.0000234610.81672.e7
更新日期:2006-09-01 00:00:00
abstract::Some modified surgical techniques are described for constructing a deep conchal cavity and pseudomeatus and obtaining high auricular projection in congenital microtia. At the primary operation, a rather small portion of the microtic vestige is utilized for the lobule by switching, sparing the skin for the concha, with...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-198604000-00004
更新日期:1986-04-01 00:00:00
abstract::Reconstruction of the nipple is the penultimate step in breast reconstruction after mastectomy. A number of reconstructive techniques have been described for nipple reconstruction including skin grafts, composite grafts, and various local flaps. The authors' preferred reconstructive technique is the local C-V or modif...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/01.PRS.0000076245.12249.BE
更新日期:2003-09-15 00:00:00
abstract:BACKGROUND:The purpose of this study was to evaluate the impact of insurance type on use of diagnostic testing, treatments, and the efficiency of care for patients with carpal tunnel syndrome. METHODS:The 2009 to 2013 Truven MarketScan Databases were used to identify adult patients with carpal tunnel syndrome. Insuran...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/PRS.0000000000002635
更新日期:2016-11-01 00:00:00