Choosing a Surgeon: How Much Experience is Enough?

Choosing a Surgeon: How Much Experience is Enough?

An old joke involves a patient asking the doctor, “Have you been successful doing this surgery?”If the doctor says, “Yes, I’ve been successful,” that means he’s done it once. If he says, “I’ve been successful in case after case,” that means he’s done it twice.

When you’re faced with surgery, this may or may not strike you as funny. But studies have shown that the surgeon’s experience is the most important factor in having as safe and successful an operation as possible.
So how do you find out your surgeon’s experience level? Ask. Be sure to do so in several different ways, and include the following questions:
  • How many times have you done this surgery yourself?
  • How many did you perform last month? Last year?
  • When did you start performing this surgery?
  • What have the outcomes been?
  • What is your complication rate?
It’s important to find out how many operations the surgeon has performed in the specifictype of surgery you’re facing. It’s a fair, reasonable question and the answer should be completely forthcoming. As with most things in life, avoid surgeons who make wild claims about their experience.
“Quantity alone is not necessarily a guarantee of quality, but it is an indication of competency,” says Joshua R. Sonett, MD, Chief, General Thoracic Surgery and Surgical Director, Lung Transplant Program, NewYork-Presbyterian Hospital/Columbia University Medical Center. Experience can be a tricky thing to evaluate, especially in the case of new procedures. If an operation is so innovative that no surgeon has performed it more than a handful of times, you might be willing to trade the lack of experience for the likely benefits. That said, if it’s an established procedure, it makes sense to find a surgeon who has performed it often and well.
How do you define “often” when it comes to surgery? That depends entirely on what kind of surgery you’re having. For example, surgeons who performed more than 30 routine shoulder replacements over a six-year period were considered "high volume" surgeons in a Maryland study. The same number, 30, also applied to hip replacement surgery.
On the other hand, James A. Lee, MD, Chief, Endocrine/Thyroid Surgery, NewYork-Presbyterian Hospital/Columbia University Medical Center, says, “A surgeon should do more than 50 thyroid operations a year to be considered an expert. In addition, the overall number of parathyroid operations he or she has done matters. I would not consider thyroid surgeons experienced until they had done at least 500 operations.”
If you can’t find surgeon experience statistics on your surgery, one simple approach is to ask your surgeon, “How many times should a surgeon have performed my operation to be considered experienced?”
And beware of any surgeon who answers, “I’ve been successful in case after case.”