Does Practice Really Make Perfect?

Editorials21 October 2003Does Practice Really Make Perfect?Christine Laine, MD, MPH, Deputy Editor and Harold C. Sox, MD, EditorChristine Laine, MD, MPH, Deputy EditorSearch for more papers by this author and Harold C. Sox, MD, EditorSearch for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-139-8-200310210-00014 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Surgery is risky. Worries include surgical errors, perioperative complications, difficult recovery, and poor long-term outcomes. Given the high stakes of surgical treatment, where should patients go when they need surgery? Common sense and a growing literature suggest that they should seek surgeons and hospitals that frequently perform the needed procedure. After all, practice makes perfect, doesn't it? Two studies reported in this issue suggest that the answer to this question is considerably more complicated than it appears (1, 2).In raising questions about volumeoutcome relationships, these studies swim against a strong current. Corporate America embraces the notion that practice makes ...References1. Meyerhardt JA, Catalano PJ, Schrag D, Ayanian JZ, Haller DG, Mayer RJ, . Association of hospital procedure volume and outcomes in patients with colon cancer at high risk for recurrence. Ann Intern Med. 2003;139:649-57. LinkGoogle Scholar2. Panageas KS, Schrag D, Riedel E, Bach PB, Begg CB. The effect of clustering of outcomes on the association of procedure volume and surgical outcomes. Ann Intern Med. 2003;139:658-65. LinkGoogle Scholar3. DoctorQuality, Inc. Accessed at www.doctorquality.com on 29 July 2003. Google Scholar4. HealthScope. Accessed at www.healthscope.org on 29 July 2003. Google Scholar5. Select Quality Care. Accessed at www.selectqualitycare.com on 29 July 2003. Google Scholar6. The Leapfrog Group. Accessed at www.leapfroggroup.org on 17 July 2003. Google Scholar7. Birkmeyer JD, Finlayson EV, Birkmeyer CM. Volume standards for high-risk surgical procedures: potential benefits of the Leapfrog initiative. Surgery. 2001;130:415-22. [PMID: 11562662] CrossrefMedlineGoogle Scholar8. Halm EA, Lee C, Chassin MR. Is volume related to outcome in health care? A systematic review and methodologic critique of the literature. Ann Intern Med. 2002;137:511-20. [PMID: 12230353] LinkGoogle Scholar9. Bates EW, Berki SE, Homan RK, Lindenauer SM. The challenge of benchmarking: surgical volume and operative mortality in Veterans Administration Medical Centers. Best Pract Benchmarking Healthc. 1996;1:34-42. [PMID: 9192589] MedlineGoogle Scholar10. Elixhauser A, Steiner C, Fraser I. Volume thresholds and hospital characteristics in the United States. Health Aff (Millwood). 2003;22:167-77. [PMID: 12674419] CrossrefMedlineGoogle Scholar11. Localio AR, Berlin JA, Ten Have TR, Kimmel SE. Adjustments for center in multicenter studies: an overview. Ann Intern Med. 2001;135:112-23. [PMID: 11453711] LinkGoogle Scholar12. Williamson JM, Datta S, Glen AS. Marginal analyses of clustered data when cluster size is informative. Biometrics. 2003; 59:36-42. [PMID: 12762439] Williamson JM, Datta S, Glen AS. Marginal analyses of clustered data when cluster size is informative. Biometrics. 2003;59:36-42. [PMID: 12762439] CrossrefMedlineGoogle Scholar13. Laine C, Markson LE, McKee LJ, Hauck WW, Fanning TR, Turner BJ. The relationship of clinic experience with advanced HIV and survival of women with AIDS. AIDS. 1998;12:417-24. [PMID: 9520172] CrossrefMedlineGoogle Scholar14. Kitahata MM, Van Rompaey SE, Dillingham PW, Koepsell TD, Deyo RA, Dodge W, . Primary care delivery is associated with greater physician experience and improved survival among persons with AIDS. J Gen Intern Med. 2003;18:95-103. [PMID: 12542583] CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: Acknowledgments: The authors thank Drs. Paul Epstein, Eliseo Guallar, Russell Localio, and Cynthia Mulrow for their careful review and helpful comments during preparation of this editorial.Corresponding Author: Customer Service, American College of Physicians, 190 N. Independence Mall West, Philadelphia, PA 19106. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoAssociation of Hospital Procedure Volume and Outcomes in Patients with Colon Cancer at High Risk for Recurrence Jeffrey A. Meyerhardt , Paul J. Catalano , Deborah Schrag , John Z. Ayanian , Daniel G. Haller , Robert J. Mayer , John S. Macdonald , Al B. Benson III , and Charles S. Fuchs The Effect of Clustering of Outcomes on the Association of Procedure Volume and Surgical Outcomes Katherine S. Panageas , Deborah Schrag , Elyn Riedel , Peter B. Bach , and Colin B. Begg Metrics Cited ByDetailed analysis of the impact of surgeon and hospital volume in microsurgical breast reconstructionConsultant volume, as an outcome determinant, in emergency medical admissionsVariation in management of early breast cancer in the Netherlands, 2003–2006Influence of caseload and surgical speciality on outcome following surgery for colorectal cancer: a review of evidence. Part 1: short-term outcomeA SYSTEMATIC REVIEW AND CRITIQUE OF THE LITERATURE RELATING HOSPITAL OR SURGEON VOLUME TO HEALTH OUTCOMES FOR 3 UROLOGICAL CANCER PROCEDURESImpact of Volume and Specialization for Cancer Surgery 21 October 2003Volume 139, Issue 8Page: 696-698KeywordsColorectal cancerHealth careHealth care qualityMedical conditionsOutpatient clinicsPatientsPopulation statisticsSurgeonsSurgerySurgical outcomes ePublished: 21 October 2003 Issue Published: 21 October 2003 CopyrightCopyright © 2003 by American College of Physicians. All Rights Reserved.PDF DownloadLoading ...