It has been clear for nearly 30 years that not all surgeons produce the same results. The reasons, however, have remained elusive. Most studies on surgical quality have focused on what surgeons do before and after surgery, practices that are easy to measure and analyze, like giving antibiotics to prevent surgical wound infections and administering blood thinners to guard against the development of blood clots.
But even with the most compulsive adherence to these pre- and post-operative protocols, and much to the chagrin of many a well-intentioned health care expert, payer and policy maker, significant disparities in patient outcomes after surgery have persisted.
The reason, observers have postulated, may be the one, obvious thing that most of these initiatives have scrupulously avoided: what goes on in the operating room.
Now an innovative collaboration between researchers, payers and weight-loss surgeons, the Michigan Bariatric Surgery Collaborative, has addressed that-which-could-not-be-named. And their findings have confirmed what patients have long suspected and trainees have long known – the dexterity of a surgeon’s hands can account for much of the differences in how well patients do. (» more)