According to the article, it is widely believed that the amount of time required to perform an operation increases when the procedure also involves training a surgical resident. The article states that this increase in time does not translate into a financial burden for the hospital. In addition, although not part of this study, other research has shown no deleterious effects of increased operative time.
Timothy J. Babineau, M.D., M.B.A., from Boston University School of Medicine, and colleagues compared the operative times of academic surgeons performing four common surgical procedures before and after the introduction of a post-graduate resident into the operating room at a community teaching hospital. Between January 1, 2001 and June 30, 2002, four academic surgeons performed operations without a resident. During that time, they either operated alone for hernia surgeries, or assisted each other for laparoscopic cholecystectomy (gall bladder removal), colectomy (removal of part of the colon), and carotid endarterectomy (removal of plaque from an artery that supplies blood to the brain). From July 1, 2002 through March 31, 2003, these same four surgeons were assisted on the same procedures by a resident physician in the third year of a post-graduate surgical training program.
The researchers found the amount of time required to perform each of the procedures increased with the addition of the surgical resident.
- Hernia surgery – increase of eight minutes
- Laparoscopic cholecystectomy – increase of 23 minutes
- Carotid endarterectomy – increase of 44 minutes
- Partial colectomy – increase of 60 minutes
The authors suggest that time spent in the operating room teaching residents represents an opportunity cost in time that the surgeon could use to meet other demands such as teaching, writing and research. "Such a cost, however, must be balanced against the time savings that residents generate by unloading many of the preoperative and postoperative patient care tasks that would otherwise fall to the attending staff," the researchers write.
(Arch Surg. 2004;139:366-370. Available post-embargo at archsurg.com)
To contact Timothy J. Babineau, M.D., M.B.A., call Gina DiGravio at 617/638-8491.
For more information, contact JAMA/Archives Media Relations at 312/464-JAMA (5262) or e-mail mediarelations@jama-archives.org .
Journal
Archives of Surgery