I don't think many people are surprised to hear that. Everyone looks for an experienced electrician, an experienced tax adviser, but how do you know you know you have found an experienced surgeon? Age certainly isn't the answer, as many younger surgeons may have better training and more experience with newer surgical procedures.
How Many Surgeries Make a Surgeon an Expert?As stated, there are numerous studies that have been performed on a variety of different types of procedures to answer this question. There is no magic number of procedures that makes a surgeon proficient, and there are many factors that influence the results of a surgical procedure.
An excellent study looked at shoulder replacement procedures in Maryland over a 6-year time frame. Surgeons who performed more than 30 replacements over that time were considered "high volume" surgeons. These doctors had a lower complication rate and their patients stayed in the hospital for a shorter time than "low volume" surgeons.
Another study that found 30 as the magic number was an evaluation of a hip replacement registry. In this study, researchers looked at characteristics that led to a higher rate of revision hip replacement. These investigators found surgeons who performed fewer than 30 hip replacements each year had a higher number of patients requiring revision surgery.
A recent study looked at spine surgery for the treatment of scoliosis. While a specific number of surgical procedures was not evaluated, the authors did find that surgeons with more than 5 years of experience with scoliosis surgery had better outcomes.
How Can You Know?Most surgeons are honest with the answers they give about their surgical experience. I think it is probably true that many surgeons tend to overestimate their experience, but I would doubt many surgeons are intentionally untruthful about their experience.
Ask your surgeon. If you doubt the answer, ask it in a few different ways, and see if things add up. Ask:
- How many times have you done this surgery?
- How many did you perform last month? Last year?
- When did you start performing this surgery?
I would suggest the following criteria:
- For commonly performed surgical procedures (including hip and knee replacement, ACL surgery, carpal tunnel surgery, and rotator cuff repair), find a surgeon who has been doing this procedure for at least 5 years, and is doing more than 30 each year.
- For less commonly performed procedures (including shoulder replacement, hip arthroscopy, meniscus transplant, and PCL reconstruction), find a surgeon who has regular experience with this surgery and has performed at least 30 procedures of that type.
Paxton EW, et al. "A Prospective Study of 80,000 Total Joint and 5000 Anterior Cruciate Ligament Reconstruction Procedures in a Community-Based Registry in the United States" J Bone & Joint Surg. 2010; 92:117-132 .
Jain N, et al. "The relationship between surgeon and hospital volume and outcomes for shoulder arthroplasty" J Bone Joint Surg Am. 2004 Mar;86-A(3):496-505.
Stanton T. "Experience is a factor in scoliosis surgery outcomes" AAOSNow, Vol 5 No 12. December 2011.