<< Back to the abstract archive
The Cost of Intra-Operative Plastic Surgery Education
Sarah E. Sasor MD, Roberto L. Flores MD,
William A. Wooden MD, and Sunil Tholpady MD PhD
Indiana University School of Medicine
2013-03-14
Presenter: Sarah E. Sasor
Affidavit:
The resident coordinated and actively participated in all activities related to this original study.
Director Name: John J. Coleman
Author Category: Resident Plastic Surgery
Presentation Category: Clinical
Abstract Category: Craniomaxillofacial
Purpose: Among surgeons, it commonly known that the length of a surgical case increases when a resident physician participates. Many hospital administrators, however, believe the opposite: that resident assistance diminishes operative time. The purpose of this study is to quantify the amount of resources invested in intra-operative teaching for index craniofacial cases.
Methods: The seven-year experience of one senior surgeon was evaluated retrospectively for CPT codes 40700 (repair of primary, unilateral cleft lip) and 42200 (palatoplasty). Variables collected included operative time, the presence or absence of a physician learner, and their PGY level, when present. A cost analysis was performed to quantify the effect of longer operative times in terms of RVUs lost.
Results: During the study period, 45 patients had primary, unilateral cleft lip repair; 70 had cleft palate repair. Of those cases, 39 (87%) cleft lip and 60 (86%) cleft palate repairs were performed with a resident or fellow. There was a statistically significant difference in the time required to perform either surgery with a physician learner present, with operative times being 160% (p=0.020) longer for cleft lip and 165% (p=0.0016) longer for cleft palate repairs. Using the 2011 RVUs for these surgeries, over $400 is invested in intra-operative teaching per case per trainee.
Conclusions: Resident involvement in the operating room is crucial to the education of independent surgeons. This involvement, however, comes at a significant cost. Per hour RVU return is diminished. As an incentive to retain academic surgeons, compensation should be offered for intra-operative teaching.
