Shaffer Christy L, Feldman Steven R, Fleischer Alan B, Huether Michael J, Chen G John
Center for Dermatology Research, Department of Dermatology, Wake Forest University School of Medicine, Winston-Salem, North Carolina 27157-1071, USA.
J Am Acad Dermatol. 2005 Jun;52(6):1045-8. doi: 10.1016/j.jaad.2005.03.049.
There has been tremendous growth in the performance of ambulatory surgical procedures. Traditional forms of peer review, commonplace for hospital-based procedures, are not typically performed in the office-based setting. Hospital credentialing of physicians has been suggested to be a means of assuring patient safety. Credentialing committees may be unaware of the level of experience of typical office-based physicians who perform cutaneous surgery.
To compare the levels of cutaneous surgery experience of dermatologists and other surgical specialists.
Medicare claims data on number of cutaneous surgery procedures performed by various medical disciplines, including dermatologists, plastic surgeons, general surgeons, and others, were obtained from the 1998-1999 Medicare Current Beneficiary Survey (MCBS) and analyzed. The number of physicians in each specialty was used to normalize the data to a per physician basis.
Dermatologists performed half (50%) of the complex repairs and most of the excisions (58%) and intermediate repairs (62%). Dermatologists performed more flaps (40% of all flaps) than any other specialty, while plastic surgeons performed more total grafts (38%) than any other specialty. Dermatologists and plastic surgeons performed similar numbers of full-thickness skin grafts, while plastic surgeons performed more split-thickness skin grafts.
As dermatologists seek hospital credentials for performing cutaneous surgery procedures, these data should help surgical colleagues understand the typical level of experience of their dermatologist colleagues.
门诊外科手术的实施数量有了巨大增长。传统的同行评审形式，在基于医院的手术中很常见，但在门诊环境中通常不会进行。有人建议对医生进行医院资质认证是确保患者安全的一种方式。资质认证委员会可能并不了解进行皮肤外科手术的典型门诊医生的经验水平。
比较皮肤科医生和其他外科专科医生的皮肤外科手术经验水平。
从1998 - 1999年医疗保险当前受益调查（MCBS）中获取了包括皮肤科医生、整形外科医生、普通外科医生等在内的各医学学科进行皮肤外科手术数量的医疗保险理赔数据，并进行分析。每个专科的医生数量用于将数据标准化到每位医生的基础上。
皮肤科医生完成了一半（50%）的复杂修复手术以及大部分切除手术（58%）和中级修复手术（62%）。皮肤科医生进行的皮瓣手术比其他任何专科都多（占所有皮瓣手术的40%），而整形外科医生进行的全层移植手术总数比其他任何专科都多（38%）。皮肤科医生和整形外科医生进行的全厚皮片移植手术数量相近，而整形外科医生进行的中厚皮片移植手术更多。
由于皮肤科医生寻求进行皮肤外科手术的医院资质，这些数据应有助于外科同行了解他们皮肤科同事的典型经验水平。
