Prestige of training programs and experience of bypass surgeons as factors in adjusted patient mortality rates

Arthur J. Hartz, Evelyn M. Kuhn, Jose S Pulido

Research output: Contribution to journalArticle

51 Citations (Scopus)

Abstract

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.

Original languageEnglish (US)
Pages (from-to)93-103
Number of pages11
JournalMedical Care
Volume37
Issue number1
DOIs
StatePublished - Jan 1999
Externally publishedYes

Fingerprint

prestige
training program
mortality
physician
Physicians
Education
Mortality
experience
Internship and Residency
Medical Schools
performance
medical specialist
Directories
Surgeons
Coronary Artery Bypass
school
surgery
Appointments and Schedules
Databases

Keywords

  • Bypass surgery
  • Measuring physician quality
  • Physician training
  • Risk-adjusted outcomes

ASJC Scopus subject areas

  • Nursing(all)
  • Public Health, Environmental and Occupational Health
  • Health(social science)
  • Health Professions(all)

Cite this

Prestige of training programs and experience of bypass surgeons as factors in adjusted patient mortality rates. / Hartz, Arthur J.; Kuhn, Evelyn M.; Pulido, Jose S.

In: Medical Care, Vol. 37, No. 1, 01.1999, p. 93-103.

Research output: Contribution to journalArticle

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