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Journal of the American Academy of Dermatology
Volume 52, n° 6
pages 1045-1048 (juin 2005)
Doi : 10.1016/j.jaad.2005.03.049
accepted : 21 February 2003
HEALTH SERVICES RESEARCH

The cutaneous surgery experience of multiple specialties in the Medicare population
 

Christy L. Shaffer a, Steven R. Feldman, MD, PhD a, , Alan B. Fleischer, MD a, Michael J. Huether, MD c, G. John Chen, PhD a, b
a From the Center for Dermatology Research, Departments of Dermatology 
b Public Health Sciences 
c Wake Forest University School of Medicine, and a private practice, Tucson 

Correspondence to: Steven R. Feldman, MD, PhD, Wake Forest University School of Medicine, Department of Dermatology, Winston-Salem, NC 27157-1071.

Winston-Salem, North Carolina, and Tucson, Arizona

Abstract
Background

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.

Purpose

To compare the levels of cutaneous surgery experience of dermatologists and other surgical specialists.

Methods

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.

Results

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.

Conclusion

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.

The full text of this article is available in PDF format.

 The Center for Dermatology Research was funded by a grant from Galderma Laboratories, LP. Dr Williford received grant support from the ASDS. Drs Feldman and Fleischer have received grant support from Bristol-Myers Squibb and from Galderma Laboratories, LP.



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