Chicago, Ill.; Cleveland, Ohio; and Philadelphia, Pa. From the Division of Plastic Surgery, Lurie Children's Hospital; the Department of Plastic Surgery and Case Statistical Consulting Center, Case Western Reserve University; and the American Board of Plastic Surgery, Inc.
Plast Reconstr Surg. 2013 Mar;131(3):425e-434e. doi: 10.1097/PRS.0b013e31827c7086.
This study compared the practice profiles of plastic surgeons applying for recertification/maintenance of certification with those applying for primary certification by the American Board of Plastic Surgery between 2003 and 2011.
American Board of Plastic Surgery case logs from both recertification and primary certification candidates from 2003 to 2011 were examined. Deidentified data included operative year, Current Procedural Terminology codes, and the candidate's designation of the case relative to (1) cosmetic or reconstructive and (2) the Maintenance of Certification in Plastic Surgery module (i.e., comprehensive, cosmetic, craniomaxillofacial, and hand). Department of Commerce unemployment data from 2003 to 2011 served as an economic indicator for the period studied.
A negative trend in the median number of cases per candidate was observed for both groups for cosmetic, reconstructive, and total number of cases, corresponding to a rise in unemployment. With every 1 percent increase in the unemployment rate, recertification candidates demonstrated a greater loss of cosmetic cases relative to primary candidates and an accelerated decline in reconstructive cases starting in 2007. Distribution of the four Maintenance of Certification modules demonstrated a negative trend for cosmetic and comprehensive cases in both groups. Hand and craniofacial consistently constituted approximately 20 percent of cases for primary and 14 percent of cases for recertification candidates. There was a shift away from hand cases toward craniofacial cases in both groups.
Both primary and recertification candidates reported a decline in overall caseload from 2003 to 2011. Negative economic trends have a greater impact on the practice profile of recertification candidates.
本研究比较了 2003 年至 2011 年间申请美国整形外科学会再认证/维持认证的整形外科医生与申请初次认证的医生的实践概况。
检查了 2003 年至 2011 年再认证和初次认证候选人的美国整形外科学会病例记录。去识别数据包括手术年份、当前程序术语 (CPT) 代码以及候选人对病例的分类（1）美容或重建，以及（2）整形外科学维持认证模块（即综合、美容、颅面和手部）。2003 年至 2011 年的商务部失业数据作为研究期间的经济指标。
对于美容、重建和总病例数，两组候选人的中位数病例数均呈负趋势，与失业率上升相对应。失业率每增加 1%，与初次认证候选人相比，再认证候选人的美容病例数损失更大，并且自 2007 年开始重建病例数下降加速。四个维持认证模块的分布在两组中均显示出美容和综合病例的负趋势。初次认证和再认证候选人的手部和颅面手术一直约占病例的 20%和 14%。两组均倾向于将手部手术转移到颅面手术。
初次认证和再认证候选人的总工作量从 2003 年到 2011 年都有所下降。负面的经济趋势对再认证候选人的实践概况影响更大。
