The cutaneous surgery experience of multiple specialties in the Medicare population.
BACKGROUND
There has been tremendous growth in the performance of ambulatory surgical procedures. Traditional forms of peer review, commonplace for hospital-based procedures, are not typically performed in the office-based setting. Hospital credentialing of physicians has been suggested to be a means of assuring patient safety. Credentialing committees may be unaware of the level of experience of typical office-based physicians who perform cutaneous surgery.


OBJECTIVE
To compare the levels of cutaneous surgery experience of dermatologists and other surgical specialists.


METHODS
Medicare claims data on number of cutaneous surgery procedures performed by various medical disciplines, including dermatologists, plastic surgeons, general surgeons, and others, were obtained from the 1998-1999 Medicare Current Beneficiary Survey (MCBS) and analyzed. The number of physicians in each specialty was used to normalize the data to a per physician basis.


RESULTS
Dermatologists performed half (50%) of the complex repairs and most of the excisions (58%) and intermediate repairs (62%). Dermatologists performed more flaps (40% of all flaps) than any other specialty, while plastic surgeons performed more total grafts (38%) than any other specialty. Dermatologists and plastic surgeons performed similar numbers of full-thickness skin grafts, while plastic surgeons performed more split-thickness skin grafts.


CONCLUSIONS
As dermatologists seek hospital credentials for performing cutaneous surgery procedures, these data should help surgical colleagues understand the typical level of experience of their dermatologist colleagues.
Shaffer
Christy L
CL
Center for Dermatology Research, Department of Dermatology, Wake Forest University School of Medicine, Winston-Salem, North Carolina 27157-1071, USA.
Feldman
Steven R
SR
Fleischer
Alan B
AB
Huether
Michael J
MJ
Chen
G John
GJ
D002983:Clinical Competence; D062109:Dermatologic Surgical Procedures; D003880:Dermatology / Q000592:standards* / Q000706:statistics & numerical data; D006801:Humans; D006278:Medicare; D013514:Surgical Procedures, Operative / Q000592:standards / Q000706:statistics & numerical data; D014481:United States