Colorectal procedures: What proportion is performed by American board of Colon and rectal surgery-certified surgeons?

David A. Etzioni, Rebecca R. Cannom, Robert D. Madoff, Glenn T. Ault, Robert W. Beart

Research output: Contribution to journalArticle

21 Scopus citations

Abstract

PURPOSE: The surgical workforce within the United States is moving rapidly toward increasing subspecialization. We hypothesized that over time an increasing proportion of colorectal procedures is performed by subspecialty-trained colorectal surgeons. METHODS: We used data from the Surveillance, Epidemiology, and End Results-Medicare program to examine the treatment of patients who underwent a colorectal surgical procedure between 1992 and 2002. We established whether the surgeon responsible for the patient's initial care was a board-certified colorectal surgeon based on a linkage with 2 overlapping data sources: 1) historical data from the American Board of Colon and Rectal Surgery and 2) the American Medical Association Physician Masterfile. RESULTS: We examined a total of 104,636 procedures; overall, 30.6% of anorectal procedures, 22.0% of proctectomies, 14.0% of ostomy-related procedures, and 11.5% of colectomies were performed by board-certified colorectal surgeons. Procedures in regions with lower population density or during urgent/emergent hospitalizations were more likely to be performed by a noncolorectal surgeon. Operations for cancer and those performed on an elective basis were more likely to be performed by a board-certified colorectal surgeon. Over time, the proportion of each of these types of cases performed by a colorectal surgeon increased. This increase was fastest for anorectal procedures. CONCLUSIONS: During the 11-year period of our study, there was a significant increase in the proportion of colorectal surgical procedures performed by board-certified colorectal surgeons.

Original languageEnglish (US)
Pages (from-to)713-720
Number of pages8
JournalDiseases of the Colon and Rectum
Volume53
Issue number5
DOIs
StatePublished - May 2010
Externally publishedYes

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Keywords

  • Colorectal cancer/economics
  • Colorectal surgery
  • Economics
  • Physician supply
  • Surgery
  • Workforce

ASJC Scopus subject areas

  • Gastroenterology

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