Nickerson R J, Colton T, Peterson O L, Bloom B S, Hauck W W
N Engl J Med. 1976 Oct 21;295(17):921-6. doi: 10.1056/NEJM197610212951704.
The generous supply of surgeons in the United States stimulated a study of their operative work based on all operations performed by all physicians in hospitals of four geographic areas. Each operation was assigned a California Relative Value to permit work-load comparisons between specialties and practices. General practitioners constituted more than one quarter of physicians who performed operations but accounted for less than one tenth of total work. Surgical specialists, about half the physicians in the study, performed about 80 per cent of total operative work. Work loads of surgical specialists varied by certification, specialty, age and practice organization status. We conclude that far too many physicians perform surgical operations and that work loads of surgical specialists are modest. Calculations involving reallocation of operative work loads suggest that the total volume of operations in this study could have been handled by a substantially smaller cadre of busier surgical specialists.
美国外科医生的充足供应促使人们基于四个地理区域医院中所有医生进行的所有手术,对外科医生的手术工作进行了一项研究。每项手术都被赋予了一个加利福尼亚相对值,以便对不同专业和医疗行为之间的工作量进行比较。全科医生占进行手术医生的四分之一以上,但在总工作量中所占比例不到十分之一。外科专科医生约占研究中医生总数的一半,完成了约80%的总手术工作量。外科专科医生的工作量因认证、专业、年龄和执业机构状况而异。我们得出的结论是,进行外科手术的医生太多了,而且外科专科医生的工作量并不大。涉及重新分配手术工作量的计算表明,本研究中的手术总量本可以由数量少得多但工作更繁忙的外科专科医生团队来处理。