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Choosing a Cancer Surgeon: Analyzing Factors in Patient Decision Making Using a Best–Worst Scaling Methodology

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Surgeon experience has been shown to influence outcomes for many types of cancer. The factors that patients consider when selecting a hospital or surgeon for cancer treatment remain poorly defined.


All patients with a cancer diagnosis seeking treatment at a surgical clinic at Johns Hopkins Hospital were asked to participate. A survey utilizing a best–worst scaling methodology was constructed to elicit the importance of various factors when selecting a cancer surgeon. Attributes were grouped into four categories: surgeon reputation, surgeon qualifications, hospital-related factors, and nonclinical factors.


Two hundred fourteen patients with a cancer diagnosis participated in the study (82.0 % response rate). Patients placed the highest value on physician qualifications and hospital-related factors. Specifically, surgeon case-specific experience (coefficient 2.56, SE 0.06) and the receipt of specialized training by the surgeon (coefficient 2.32, SE 0.06) ranked highest (both P < 0.001). Among hospital-related factors, hospital case-specific volume (coefficient 1.32, SE 0.06; P < 0.001) was most important. The lowest rated factors were parking availability (coefficient −2.81, SE 0.06) and home-to-clinic distance (coefficient −2.12, SE 0.06) (both P < 0.001). The majority of patients reported their ideal surgeon to have at least 6 years of experience (n = 143, 68.1 %) and to have performed their specific procedure at least 50 times (n = 156, 75.3 %).


Patients consider several factors when choosing a cancer surgeon. Surgeon qualifications and hospital-related factors appear to be most influential in their decision. Easier and more widespread dissemination of surgeon and hospital cancer data such as case volume may be useful for patients.

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Aslam Ejaz was supported in part by the Eleanor B. Pillsbury Foundation for surgical research.


The authors declare no conflict of interest.

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Correspondence to Timothy M. Pawlik MD, MPH, PhD.

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Ejaz, A., Spolverato, G., Bridges, J.F. et al. Choosing a Cancer Surgeon: Analyzing Factors in Patient Decision Making Using a Best–Worst Scaling Methodology. Ann Surg Oncol 21, 3732–3738 (2014).

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