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Difficult Decisions in Thoracic Surgery pp 47–57Cite as

Decision Making: The Surgeon’s Perspective

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Part of the book series: Difficult Decisions in Surgery: An Evidence-Based Approach ((DDSURGERY,volume 1))

Abstract

Delivery of medical advice is characterized by a process of weighing, prioritizing and structuring information given to a patient into a decision. In the ideal world, this is evidence-based. However, non-clinical factors can influence the decision-making process. The current chapter will briefly review models of the surgeon-patient relationship, and focus on those factors that influence the decision-making process from the surgeon’s perspective. A subsequent chapter will focus on issues from the patient perspective.

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References

  1. Cooper JD, Trulock EP, Triantafillou AN, et al. Bilateral pneumectomy (volume reduction) for chronic obstructive pulmonary disease. J Thorac Cardiovasc Surg. 1995;109:106–19.

    Article  CAS  PubMed  Google Scholar 

  2. Ramsey SD, Sullivan SD. Evidence, economics and emphysema: Medicare’s long journey with lung volume reduction surgery. Health Aff (Millwood). 2005;24:55–66.

    Article  Google Scholar 

  3. The National Emphysema Treatment Trial Research Group. Rationale and design of the National Emphysema Treatment Trial (NETT): a prospective randomized trial of lung volume reduction surgery. J Thorac Cardiovasc Surg. 1999;118:518–28.

    Article  Google Scholar 

  4. Cooper JD. Paying the piper: the NETT strikes a sour note. National Emphysema Treatment Trial. Ann Thorac Surg. 2001;72:330–3.

    Article  CAS  PubMed  Google Scholar 

  5. Huizenga HF, Ramsey SD, Albert RK. Estimated growth of lung volume reduction surgery among Medicare enrollees: 1994 to 1996. Chest. 1998;114:1583–7.

    Article  CAS  PubMed  Google Scholar 

  6. National Emphysema Treatment Trial Research Group. A randomized trial comparing lung volume-reduction surgery with medical therapy for severe emphysema. N Engl J Med. 2003;348:2059–73.

    Article  Google Scholar 

  7. Lee EO, Emanuel EJ. Shared decision making to improve care and reduce costs. Engl J Med. 2005;1:6–8.

    Google Scholar 

  8. Clark JA, Potter DA, McKinlay JB. Bringing social structure back into clinical decision making. Soc Sci Med. 1991;32:853–66.

    Article  CAS  PubMed  Google Scholar 

  9. Tubbs EP, Broekel Elrod JA, Flum DR. Risk taking and tolerance for uncertainty: implications for surgeons. J Surg Res. 2006;131:1–6.

    Article  PubMed  Google Scholar 

  10. Nightingale SD. Risk preference and laboratory use. Med Decis Making. 1987;7:168–72.

    Article  CAS  PubMed  Google Scholar 

  11. Nightingale SD. Risk preference and admitting rates of emergency room physicians. Med Care. 1988;26:84–7.

    Article  CAS  PubMed  Google Scholar 

  12. Nightingale SD. Risk preference and decision making in critical care situations. Chest. 1988;93:684–7.

    Article  CAS  PubMed  Google Scholar 

  13. Holtgrave DR, Lawler F, Spann SJ. Physicians’ risk attitudes, laboratory usage, and referral decisions: the case of an academic family practice center. Med Decis Making. 1991;11:125–30.

    Article  CAS  PubMed  Google Scholar 

  14. Zaat JOM. General practitioners’ uncertainty, risk preference and use of laboratory tests. Med Care. 1992;30:846–54.

    Article  CAS  PubMed  Google Scholar 

  15. Greenfield LJ, Proctor MC. When should a surgeon retire? Adv Surg. 1999;32:385–93.

    CAS  PubMed  Google Scholar 

  16. Trunkey DD, Botney R. Assessing competency: a tale of two professions. J Am Coll Surg. 2001;192:385–95.

    Article  CAS  PubMed  Google Scholar 

  17. Choudhry NK, Fletcher RH, Soumerai SB. Systematic review: the relationship between clinical experience and quality of health care. Ann Intern Med. 2005;142:260–73.

    Article  PubMed  Google Scholar 

  18. Freiman MP. The rate of adoption of new procedures among physicians. The impact of specialty and practice characteristics. Med Care. 1985;23:939–45.

    Article  CAS  PubMed  Google Scholar 

  19. Hlatky MA, Cotugno H, O’Connor C, Mark DB, Pryor DB, Califf RM. Adoption of thrombolytic therapy in the management of acute myocardial infarction. Am J Cardiol. 1988;61:510–4.

    Article  CAS  PubMed  Google Scholar 

  20. Young MJ, Fried LS, Eisenberg J, Hershey J, Williams S. Do cardiologists have higher thresholds for recommending coronary arteriography than family physicians? Health Serv Res. 1987;22:623–35.

    CAS  PubMed Central  PubMed  Google Scholar 

  21. Nakata Y, Okuno-Fujiwara M, Goto T, Morita S. Risk attitudes of anesthesiologists and surgeons in clinical decision making with expected years of life. J Clin Anesth. 2000;12:146–50.

    Article  CAS  PubMed  Google Scholar 

  22. American College of Surgeons Health Policy Research Institute. The surgical workforce in the United States: profile and recent trends. Apr 2010. Accessed at http://www.acshpri.org/documents/ACSHPRI_Surgical_Workforce_in_US_apr2010.pdf.

  23. Darves B. Women physicians in the specialties: making gains. N Eng J Med Career Center. 19 Sept 2012. Accessed at http://www.nejmcareercenter.org/article/women-physicians-in-the-specialties-making-gains/.

  24. Roter DL, Hall JA. Why physician gender matters in shaping the physician-patient relationship. J Womens Health. 1998;7:1093–7.

    Article  CAS  PubMed  Google Scholar 

  25. Roter D, Lipkin Jr M, Korsgarrd A. Sex differences in patients’ and physicians’ communications during primary care medical visits. Med Care. 1991;29:1083–93.

    Article  CAS  PubMed  Google Scholar 

  26. Van den Bronk-Muinen A, Bensing JM, Kerssens JJ. Gender and communication style in general practice. Differences between women’s health care and regular health care. Med Care. 1998;36:100–6.

    Article  Google Scholar 

  27. Cowan Jr JA, Dimick JB, Thompson BG, et al. Surgeon volume as an indicator of outcomes after carotid endarterectomy: an effect independent of specialty practice and hospital volume. J Am Coll Surg. 2022;195:814–21.

    Article  Google Scholar 

  28. Goodney PP, Lucas FL, Stukel TAA, Birkmeyer JD. Surgeon specialty and operative mortality with lung resection. Ann Surg. 2005;241:179–84.

    PubMed Central  PubMed  Google Scholar 

  29. Farjah F, Flum DR, Varghese Jr TK, et al. Surgeon specialty and long-term survival after pulmonary resection for lung cancer. Ann Thorac Surg. 2009;87:995–1006.

    Article  PubMed  Google Scholar 

  30. Dimick JB, Goodney PP, Orringer MB, Birkmeyer JD. Specialty training and mortality after esophageal cancer resection. Ann Thorac Surg. 2005;80:282–6.

    Article  PubMed  Google Scholar 

  31. Lee PV, Berenson RA, Tooker J. Payment reform – the need to harmonize approaches in Medicare and the private sector. N Engl J Med. 2010;362:3–5.

    Article  CAS  PubMed  Google Scholar 

  32. Ein D, Jefferson A. The patient protection and affordable care act: causes and effects. Ann Allergy Asthma Immunol. 2014;112:6–8.

    Article  PubMed  Google Scholar 

  33. Devettere RJ. Making health care decisions. In: Devettere RJ, editor. Practical decision making in health care ethics. Washington, DC: Georgetown University Press; 2000. p. 94.

    Google Scholar 

  34. Itani KM. Fifteen years of the National Surgical Quality Improvement Program in review. Am J Surg. 2009;198(5 Suppl):S9–18.

    Article  PubMed  Google Scholar 

  35. SAGES guidelines for laparoscopic resection of curable colon and rectal cancer. Feb 2012. Accessed at http://www.sages.org/publications/guidelines/guidelines-for-laparoscopic-resection-of-curable-colon-and-rectal-cancer/.

  36. Topol EJ, Califf RM. Scorecard cardiovascular medicine. Its impact and future directions. Ann Intern Med. 1994;120:65–70.

    Article  CAS  PubMed  Google Scholar 

  37. Hannan EL, Kilburn Jr H, O’Donnell JF, et al. Adult open heart surgery in New York State. An analysis of risk factors and hospital mortality rate. JAMA. 1990;264:2768–74.

    Article  CAS  PubMed  Google Scholar 

  38. Epstein A. Performance reports on quality – prototypes, problems and prospects. N Engl J Med. 1995;333:57–61.

    Article  CAS  PubMed  Google Scholar 

  39. Narins CR, Dozier AM, Ling FS, Zareba W. The influence of public reporting of outcome data on medical decision making by physicians. Arch Intern Med. 2005;165:83–7.

    Article  PubMed  Google Scholar 

  40. Schneider EC, Epstein AM. Use of public performance reports: a survey of patients undergoing cardiac surgery. JAMA. 1998;279:1638–42.

    Article  CAS  PubMed  Google Scholar 

  41. Prager RL, Armenti FR, Bassett JS, et al. Cardiac surgeons and the quality movement: the Michigan experience. Semin Thorac Cardiovasc Surg. 2009;21:20–7.

    Article  PubMed  Google Scholar 

  42. Flum DR, Fisher N, Thompson J, et al. Washington State’s approach to variability in surgical processes/outcomes: Surgical Clinical Outcomes Assessment Program (SCOAP). Surgery. 2005;138:821–8.

    Article  PubMed  Google Scholar 

  43. Aldea GS, Mokadam NA, Melford R, et al. Changing volumes, risk profiles, and outcomes of coronary artery bypass grafting and percutaneous coronary interventions. Ann Thorac Surg. 2009;87:1828–38.

    Article  PubMed  Google Scholar 

  44. Clark RE. The STS Cardiac Surgery National Database: an update. Ann Thorac Surg. 1995;59:1376–81.

    Article  CAS  PubMed  Google Scholar 

  45. Wright CD, Gaissert HA, Grab JD, et al. Predictors of prolonged length of stay after lobectomy for lung cancer: a Society of Thoracic Surgeons General Thoracic Database risk-adjustment model. Ann Thorac Surg. 2008;85:1857–65.

    Article  PubMed  Google Scholar 

  46. Cassel CK, Guest JA. Choosing Wisely: helping physicians and patients make smart decisions about their care. JAMA. 2012;307:1801–2.

    Article  CAS  PubMed  Google Scholar 

  47. Wood DE, Mitchell JD, Schmitz DS, et al. Choosing Wisely: cardiothoracic surgeons partnering with patients to make good health care decisions. Ann Thorac Surg. 2013;95(3):1130–5.

    Article  PubMed  Google Scholar 

  48. Mayer Jr JR. Ethical, legal and health policy challenges in contemporary cardiothoracic surgery: introduction. Semin Thorac Cardiovasc Surg. 2009;21:1–2.

    Article  PubMed  Google Scholar 

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Author information

Authors and Affiliations

  1. Department of Surgery, Harborview Medical Center, University of Washington, 359796, 325 Ninth Ave., Seattle, WA, 98104, USA

    Thomas K. Varghese Jr. MD, MS, FACS

Authors
  1. Thomas K. Varghese Jr. MD, MS, FACS
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Correspondence to Thomas K. Varghese Jr. MD, MS, FACS .

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Editors and Affiliations

  1. Surgery, University of Chicago, Chicago, Illinois, USA

    Mark K. Ferguson

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© 2014 Springer-Verlag London

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Cite this chapter

Varghese, T.K. (2014). Decision Making: The Surgeon’s Perspective. In: Ferguson, M. (eds) Difficult Decisions in Thoracic Surgery. Difficult Decisions in Surgery: An Evidence-Based Approach, vol 1. Springer, London. https://doi.org/10.1007/978-1-4471-6404-3_4

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  • DOI: https://doi.org/10.1007/978-1-4471-6404-3_4

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  • Publisher Name: Springer, London

  • Print ISBN: 978-1-4471-6403-6

  • Online ISBN: 978-1-4471-6404-3

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