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Looking Over the Drape—Anesthesiologists’ Volume and Surgical Outcomes—Reply

Looking Over the Drape—Anesthesiologists’ Volume and Surgical Outcomes—Reply Letters steadily decreasing autonomy. Furthermore, in 2003, the Joint ing gastrointestinal cancer surgery. The authors must be Commission instituted the Universal Protocol mandating that congratulated for the advanced methodology by which they attending physicians be present for a time out at case start. This have ascertained that care by high-volume anesthesiologists might explain the decrease in cases that Itani et al described was independently associated with lower odds of major mor- with an attending physician not in the operating room, but bidity, unplanned intensive care unit admission, and the com- there was no mandate by Joint Commission or VAMCs that the posite of 90-day major morbidity and readmission in patients attending physician scrub in. None of the factors outlined jus- undergoing esophagectomy, pancreatectomy, or hepatec- tify the progressive decrease in resident physician au- tomy for oncologic indications. The quality of results was tonomy. We must work to increase opportunities for trainee boosted by integrating information from multiple data sets operative autonomy if we hope to have a skilled surgical work- whose data cleaning and validity had been previously proven force in the future. by formal studies. We found particularly thought provoking that an anesthesiologist to surgeon ratio of 4.5 http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png JAMA Surgery American Medical Association

Looking Over the Drape—Anesthesiologists’ Volume and Surgical Outcomes—Reply

JAMA Surgery , Volume 157 (1) – Jan 29, 2022

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References (4)

Publisher
American Medical Association
Copyright
Copyright 2021 American Medical Association. All Rights Reserved.
ISSN
2168-6254
eISSN
2168-6262
DOI
10.1001/jamasurg.2021.3756
Publisher site
See Article on Publisher Site

Abstract

Letters steadily decreasing autonomy. Furthermore, in 2003, the Joint ing gastrointestinal cancer surgery. The authors must be Commission instituted the Universal Protocol mandating that congratulated for the advanced methodology by which they attending physicians be present for a time out at case start. This have ascertained that care by high-volume anesthesiologists might explain the decrease in cases that Itani et al described was independently associated with lower odds of major mor- with an attending physician not in the operating room, but bidity, unplanned intensive care unit admission, and the com- there was no mandate by Joint Commission or VAMCs that the posite of 90-day major morbidity and readmission in patients attending physician scrub in. None of the factors outlined jus- undergoing esophagectomy, pancreatectomy, or hepatec- tify the progressive decrease in resident physician au- tomy for oncologic indications. The quality of results was tonomy. We must work to increase opportunities for trainee boosted by integrating information from multiple data sets operative autonomy if we hope to have a skilled surgical work- whose data cleaning and validity had been previously proven force in the future. by formal studies. We found particularly thought provoking that an anesthesiologist to surgeon ratio of 4.5

Journal

JAMA SurgeryAmerican Medical Association

Published: Jan 29, 2022

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