Referral From One Surgeon to Another to Reduce Maximum Waiting Time

Studies of shared (patient-provider) decision making for elective surgical care have examined both the decision whether to have surgery and patients’ understanding of treatment options | Anesthesia & Analgesia

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Background: We consider shared decision making applied to case scheduling, since implementation would reduce labor costs.

Methods: Study questions were presented in sequence of waiting times, starting with 4 workdays. “Assume the consultant surgeon (ie, the surgeon in charge) you met in clinic did not have time available to do your surgery within the next 4 workdays, but his/her colleague would have had time to do your surgery within the next 4 workdays. Would you have wanted to discuss with a member of the surgical team (eg, the scheduler or the surgeon) the availability of surgery with a different, equally qualified surgeon at Mayo Clinic who had time available within the next 4 workdays, on a date of your choosing?” There were 980 invited patients who underwent lung resection or cholecystectomy between 2011 and 2016; 135 respondents completed the study and 6 respondents dropped out after the study questions were displayed.

Results: The percentages of patients whose response to the study questions was “4 days” were 58.8% (40/68) among lung resection patients and 58.2% (39/67) among cholecystectomy patients. The 97.5% 2-sided confidence interval for the median maximum wait was 4 days to 4 days. Patients’ choices for the waiting time sufficient to discuss having another surgeon perform the procedure did not differ between procedures (P = .91). Results were insensitive to patients’ sex, age, travel time to hospital, or number of office visits before surgery (all P >= .20).

Conclusion: Our results indicate that bringing up the option with the patient of changing surgeons when a colleague is available and has the operating room time to perform the procedure sooner is being respectful of most patients’ individual preferences (ie, patient-centered).

Full reference: Logvinov, I. I. et al. (2017) Patient Survey of Referral From One Surgeon to Another to Reduce Maximum Waiting Time for Elective Surgery and Hours of Overutilized Operating Room Time. Anesthesia & Analgesia: Post Author Corrections: July 10, 2017

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