title: A Systematic Review of the Factors that Patients Use to Choose their Surgeon.
abstract: BACKGROUND
  Given surgery's inherent risks, a patient should be able to make the most informed decisions possible in selecting surgical treatment. However, there is little information on what factors patients deem important when choosing a surgeon. We performed a systematic review of the literature focused on how patients select surgical care, focusing on identification of factors that influence patient choice as well as important sources of information used by patients.
  
  
  METHODS
  A search of all available literature on factors associated with choice of surgeon/surgical care, as well as sources of information used by patients before undergoing surgery, was conducted using the MEDLINE/PubMed electronic database.
  
  
  RESULTS
  Of the 2315 publications identified, 86 studies met inclusion criteria. Overall, patients draw upon a wide range of factors when choosing surgical care. Surgeon reputation and competency stood out as the most valued professional attributes. Patients also often selected surgeons based on their interpersonal skills. Many patients chose surgical care using hospital, rather than surgeon, characteristics. For these patients, hospital reputation and hospital distance were factors of primary importance. Importantly, most patients relied on word-of-mouth and physician referrals when choosing a surgeon. Patients also expressed interest in quality information on surgeons, indicating that these data would be useful in decision-making.
  
  
  CONCLUSIONS
  Patients draw upon a myriad of factors when choosing a surgeon and the circumstances surrounding patients' decisions maybe differ based on sociodemographic, cultural, as well as other factors. Additional information on how patients choose surgeons or hospitals will help providers assist patients in finding their preferred caregivers.
authors.affiliation: Division of Surgical Oncology, Department of Surgery, John L. Cameron Professor of Alimentary Surgery, Johns Hopkins Hospital, 600 N. Wolfe Street, Blalock 688, Baltimore, MD, 21287, USA.
authors.forename: Alexander T
authors.initials: AT
authors.lastname: Yahanda
authors.affiliation: Center for Pancreatic Cancer Research, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
authors.forename: Kelly J
authors.initials: KJ
authors.lastname: Lafaro
authors.affiliation: Division of Surgical Oncology, Department of Surgery, John L. Cameron Professor of Alimentary Surgery, Johns Hopkins Hospital, 600 N. Wolfe Street, Blalock 688, Baltimore, MD, 21287, USA.
authors.forename: Gaya
authors.initials: G
authors.lastname: Spolverato
authors.affiliation: Division of Surgical Oncology, Department of Surgery, John L. Cameron Professor of Alimentary Surgery, Johns Hopkins Hospital, 600 N. Wolfe Street, Blalock 688, Baltimore, MD, 21287, USA. tpawlik1@jhmi.edu.
authors.forename: Timothy M
authors.initials: TM
authors.lastname: Pawlik
mesh_terms: D002755:Choice Behavior; D003657:Decision Making; D006761:Hospitals; D006801:Humans; D057240:Patient Preference; D012017:Referral and Consultation; D066231:Surgeons; D000078329:Workforce