How surgeon age affects post-treatment surveillance strategies for melanoma patients.
The intensity of post-treatment melanoma patient follow-up varies widely among physicians. We investigated whether physician age accounts for the observed variation in surveillance intensity among plastic surgeons. A custom-designed questionnaire was mailed to USA and non-USA surgeons, all of whom were members of the American Society of Plastic and Reconstructive Surgeons. Subjects were asked how they use 14 specific follow-up modalities during years 1-5 and 10 following primary treatment for patients with cutaneous melanoma. Repeated-measures analysis of variance was used to compare practice patterns by TNM stage, year post-surgery, and age. Of the 3,032 questionnaires mailed, 1,142 (38%) were returned. Of those returned, 395 (35%) were evaluable. Non-evaluability was usually due to lack of melanoma patient follow-up in surgeons' practices. Follow-up strategies for most of the 14 modalities were highly correlated across TNM stages and years post-surgery, as expected. The pattern of testing varied significantly by surgeon age for 3 modalities (complete blood count, liver function tests, and chest X-ray), but the variation was quite small. We concluded that the post-treatment surveillance practice patterns of ASPRS members caring for patients with cutaneous melanoma vary only marginally with physician age. Continuing medical education could account for this observation.
Margenthaler
J A
JA
Department of Surgery, Saint Louis University Health Sciences Center, and Surgical Service, John Cochran Veterans Affairs Medical Center, St. Louis, MO 63110-0250, USA.
Virgo
K S
KS
Johnson
D Y
DY
Sugarbaker
E M
EM
Handler
B S
BS
Johnson
F E
FE
D000328:Adult; D000367:Age Factors; D001772:Blood Cell Count; D005500:Follow-Up Studies; D006801:Humans; D008545:Melanoma / Q000175:diagnosis* / Q000601:surgery; D008875:Middle Aged; D009367:Neoplasm Staging; D011182:Postoperative Care / Q000706:statistics & numerical data*; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D013902:Radiography, Thoracic; D012878:Skin Neoplasms / Q000175:diagnosis* / Q000601:surgery; D011795:Surveys and Questionnaires