Department of Surgery, University of Alabama at Birmingham, Birmingham, Alabama.
Department of Surgery, Drexel University College of Medicine, Philadelphia, Pennsylvania.
J Surg Res. 2019 Dec;244:348-351. doi: 10.1016/j.jss.2019.06.056. Epub 2019 Jul 16.
Surgical fields are becoming increasingly specialized. This can lead to misunderstanding or confusion about the scope of practice of different surgeons by the individual seeking specialized surgical care. To assess public understanding of subspecialty surgeons, we sought to survey general knowledge of the specialty areas of Endocrine Surgery and Vascular Surgery.
A survey was conducted in three locations in Birmingham, Alabama: a local farmers market, a public park, and the University of Alabama at Birmingham hospital. Fifty people were surveyed at random at each of the three locations, with hospital staff identified by wearing a hospital ID badge recruited at the University of Alabama at Birmingham hospital location. Participants were asked to define both an endocrine surgeon and vascular surgeon, as well as identify aspects of their practice. Participant's answers to the survey were recorded and coded by three evaluators (two MDs, one PharmD candidate). Survey responses were assessed for correct definition of the specialty (yes/no), recognition of being a surgeon (yes/no), spectrum of practice (none, partial, or complete), and presence of a common misconception (yes/no). Interrater reliability (kappa) was calculated for each question. Chi-square test was used to compare the difference in each answer between the two specialties.
A total of 150 people participated in the study. The majority were female (58%) and approximately 50 y of age or less (65%). Interrater reliability from 0.32 to 0.84 was observed, and agreement from 40% to 98% between raters was achieved for all questions. Significantly more respondents recognized endocrine surgery as a surgical profession (21%) compared to vascular surgeons (18%) (P < 0.001). However, significantly fewer could define what an endocrine surgeon does (14%) than could define what a vascular surgeon does (57%). Only 3% of respondents could identify the entire spectrum of practice of an endocrine surgeon, with 42% and 55% providing partially or completely incorrect responses, respectively. Significantly more respondents could identify all of a vascular surgeon's spectrum of practice (11%), with 60% and 29% providing partial or completely incorrect responses, respectively (P < 0.001). Endocrine surgeons were most often confused for endocrinologists (40%), whereas vascular surgeons were most often confused for cardiovascular surgeons (22%).
This study reveals an overall lack of understanding among the general public about what endocrine and vascular surgeons are and their spectrum of practice and shows that public understanding of the field of endocrine surgery is very low. More efforts need to be made to increase the visibility of these fields and communicate these surgeons' specialized expertise.
外科领域的专业化程度越来越高。这可能导致寻求专业外科护理的个人对不同外科医生的执业范围产生误解或混淆。为了评估公众对亚专科外科医生的理解，我们调查了普通民众对内分泌外科和血管外科专业领域的基本知识。
在阿拉巴马州伯明翰的三个地点进行了一项调查：当地农贸市场、一个公共公园和阿拉巴马大学伯明翰分校医院。在这三个地点的每个地点随机调查了 50 人，在阿拉巴马大学伯明翰分校医院地点，佩戴医院身份证的医院工作人员被招募。要求参与者定义内分泌外科医生和血管外科医生，并确定他们的执业范围。由三名评估者（两名医生，一名药学博士候选人）记录和编码参与者的调查回答。评估调查回答是否正确定义专业（是/否）、是否识别为外科医生（是/否）、执业范围（无、部分或全部）以及是否存在常见误解（是/否）。计算每个问题的评估者间可靠性（kappa）。使用卡方检验比较两个专业之间每个答案的差异。
共有 150 人参加了这项研究。大多数人是女性（58%），年龄在 50 岁或以下（65%）。观察到评估者间可靠性为 0.32 至 0.84，所有问题的评估者间一致性为 40%至 98%。与血管外科医生（18%）相比，更多的受访者将内分泌手术识别为一种外科专业（21%）（P<0.001）。然而，能够定义内分泌外科医生做什么的人（14%）明显少于能够定义血管外科医生做什么的人（57%）。只有 3%的受访者能够确定内分泌外科医生的整个执业范围，分别有 42%和 55%的人提供了部分或完全错误的回答。更多的受访者能够确定血管外科医生的整个执业范围（11%），分别有 60%和 29%的人提供了部分或完全错误的回答（P<0.001）。内分泌外科医生最常被误认为是内分泌学家（40%），而血管外科医生最常被误认为是心血管外科医生（22%）。
这项研究揭示了普通民众对外科医生和血管外科医生的理解程度普遍较低，他们对这些医生的执业范围了解甚少。需要进一步努力提高这些领域的知名度，并传达这些外科医生的专业专长。
