title: Outcomes of physician patients after non-cardiac surgery: a registry analysis.
abstract: When physicians become patients, they may expect special privileges, extra attention from caregivers, and non-routine treatments. Consequently, physician patients may not be treated per routine-which possibly worsens care rather than improving it. We thus tested the primary hypothesis that in-hospital mortality and major complications after non-cardiac surgery are more common in physician patients than in non-physician patients.
  
  
  
  Perioperative data were extracted for patients who had non-cardiac surgery at the Cleveland Clinic between 2005 and 2013. We used propensity score matching to identify comparable groups of physician and non-physician patients. Matched physician and non-physician patients were compared on a composite of in-hospital mortality and major postoperative complications using a generalized equation average relative effects model. Secondly, the matched patients were also compared on reoperation using logistic regression and on duration of hospitalization using Kaplan-Meier analysis with the log-rank test and Cox proportional hazards regression.
  
  
  
  Among 21,173 qualifying patients, we matched 522 physician patients to 2448 non-physician controls. There were no significant differences between physician and non-physician patients in the composite of in-hospital mortality and major complications, with an estimated odds ratio across the outcome components (average relative effect) of 1.20 (95% confidence interval 0.77-1.87) for physicians vs. non-physicians, P = 0.41. There was also no difference in the risk of re-operation or duration of hospitalization.
  
  
  
  A variety of important outcomes were similar in physician patients and matched non-physician patients after non-cardiac surgery.
authors: Department of Outcomes Research, Anesthesiology Institute, Cleveland Clinic, 9500 Euclid Ave P77, Cleveland, OH, 44195, USA.
authors: Krit
authors: K
authors: Panjasawatwong
authors: Department of Outcomes Research, Anesthesiology Institute, Cleveland Clinic, 9500 Euclid Ave P77, Cleveland, OH, 44195, USA.
authors: Peirong
authors: P
authors: Lin
authors: Department of Outcomes Research, Anesthesiology Institute, Cleveland Clinic, 9500 Euclid Ave P77, Cleveland, OH, 44195, USA.
authors: Nika
authors: N
authors: Karimi
authors: Department of Outcomes Research, Anesthesiology Institute, Cleveland Clinic, 9500 Euclid Ave P77, Cleveland, OH, 44195, USA.|Departments of Quantitative Health Science, Cleveland Clinic, 9500 Euclid Ave P77, Cleveland, OH, 44195, USA.
authors: Jing
authors: J
authors: You
authors: Department of Outcomes Research, Anesthesiology Institute, Cleveland Clinic, 9500 Euclid Ave P77, Cleveland, OH, 44195, USA. DS@OR.org.
authors: Daniel I
authors: DI
authors: Sessler
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D017052:Hospital Mortality; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D053208:Kaplan-Meier Estimate; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D010820:Physicians / Q000706:statistics & numerical data*; D011183:Postoperative Complications / Q000453:epidemiology*; D012042:Registries; D012086:Reoperation / Q000706:statistics & numerical data
keywords: Anesthesia; Health services; Mortality; Physician patient; Surgery; Visiting important person