Prestige of Training Programs and Experience of Bypass Surgeons As Factors in Adjusted Patient Mortality Rates

OBJECTIVES: The relation of physician performance to physician training and experience is not well understood. The aim of this study was to examine whether indicators of physician background and experience were associated with an objective measure of physician performance. METHODS: Physician background information obtained from the Directory of Board-Certified Medical Specialists was linked to physician risk-adjusted mortality rates obtained from three statewide data bases of coronary artery bypass surgeons. Subjects were 275 surgeons who performed CABG surgery on 83,547 patients during the years 1989 to 1992. Surgical performance was measured by the mortality ratio (MR), the ratio of the observed to the predicted patient mortality rate as determined by detailed clinical information. Training institutions and physicians were characterized as prestigious if they were listed as outstanding in published articles. RESULTS: Surgical performance was not associated with graduation from an American medical school; attendance at a prestigious medical school, residency, or fellowship program; or an academic appointment. Mortality ratios decreased with increased volume and increased with years of experience, age, and academic rank. Surgeons were more likely to be considered a "best doctor" if they had more years experience and trained at a prestigious residency or fellowship program. CONCLUSIONS: Training at a prestigious institution was associated with identification as a "best" doctor but not with lower mortality ratios

Academic institution · Attendance · Board certification · Certification · Continuing education · Family medicine · Graduation (instrument) · Medical education · Medical school · Mortality rate · Residency training · Specialty · Diversity and Career in Medicine · Medicine · Patient Satisfaction in Healthcare · Surgery · Surgical Simulation and Training · Gerontology

• Systematic Review

  Open Access•Niteesh K Choudhry, Robert H Fletcher et al.•Annals of Internal Medicine•2005

  Añadir item

• Hospital Characteristics and Mortality Rates

  Arthur J Hartz, Henry Krakauer et al.•New England Journal of Medicine•1989

  Añadir item

• Assessing providers of coronary revascularization

  Arthur J Hartz, Evelyn M Kuhn et al.•American Journal of Public Health•1992

  Añadir item

• The Relationship of Hospital Characteristics and the Results of Peer Review in Six Large States

  Evelyn M Kuhn, Arthur J Hartz et al.•Medical Care•1991

  Añadir item

• A performance comparison

  Robert M Saywell, James Studnicki et al.•American Journal of Public Health•1979

  Añadir item

• Comparing hospitals that perform coronary artery bypass surgery

  Arthur J Hartz, Evelyn M Kuhn•American Journal of Public Health•1994

  Añadir item

• Are the best coronary artery bypass surgeons identified by physician surveys

  Arthur J Hartz, José S Pulido et al.•American Journal of Public Health•1997

  Añadir item

• The Relation Between Surgical Volume and Mortality

  Harold S Luft•Medical Care•1980

  Añadir item

• Does Practice Make Perfect

  Ann Barry Flood, W Richard Scott et al.•Medical Care•1984

  Añadir item

• Use of Diagnostic Services by Physicians in Community Practice

  John M Eisenberg, David Nicklin•Medical Care•1981

  Añadir item

• Coronary Artery Bypass Surgery

  Edward L Hannan, Harold Kilburn et al.•Medical Care•1991

  Añadir item

• Non-Medical Factors Influencing Use of Diagnostic X-ray by Physicians

  Alfred W Childs, E Diane Hunter•Medical Care•1972

  Añadir item

• USMGs Versus FMGs

  Sang-O Rhee, Thomas F Lyons et al.•Medical Care•1986

  Añadir item

• Factors Determining the Quality of Physician Performance in Patient Care

  Sang-O Rhee•Medical Care•1976

  Añadir item

• The General Practitioner

  Howard S Becker, Kenneth F Clute•American Sociological Review•1963

  Añadir item