ArticlePerioperative medicine (London, England)2017
Surgeons' views on preoperative medical evaluation: a qualitative study.
Article in Perioperative medicine (London, England), 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
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Who cites it
7 citing papers in PubMed.
- Targets for De-implementation of Unnecessary Testing Before Low-Risk Surgery: A Qualitative Study.The Journal of surgical research · 2024Article
- Development and Validation of an Electronic Health Record-based Score for Triage to Perioperative Medicine.Annals of surgery · 2023Article
- Is Low-value Testing Before Low-risk Hand Surgery Associated With Increased Downstream Healthcare Use and Reimbursements? A National Claims Database Analysis.Clinical orthopaedics and related research · 2022Article
- Hospital doctors' attitudes to brief educational messages that aim to modify diagnostic test requests: a qualitative study.BMC medical informatics and decision making · 2020Article
- Surgeons' Views on Shared Decision-Making.Journal of patient-centered research and reviews · 2020Article
- Factors influencing day surgery patients' quality of postoperative recovery and satisfaction with recovery: a narrative review.Perioperative medicine (London, England) · 2019Review
- Role of Patient- and Surgery-Specific Risk in Receipt of Outpatient Preoperative Testing.Perioperative care and operating room management · 2018Article
Corrections and comments
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Authors and funding
5 authors.
Funding
Abstract
backgroundThere is substantial variation in the practice of preoperative medical evaluation (PME) and limited evidence for its benefit, which raises concerns about overuse. Surgeons have a unique role in this multidisciplinary practice. The objective of this qualitative study was to explore surgeons' practices and their beliefs about PME.
methodsWe conducted of semi-structured interviews with 18 surgeons in Baltimore, Maryland. Surgeons were purposively sampled to maximize diversity in terms of practice type (academic vs. private practice), surgical specialty, gender, and experience level. General topics included surgeons' current PME practices, perceived benefits and harms of PME, the surgical risk assessment, and potential improvements and barriers to change. Interviews were audio-recorded and transcribed. Transcripts were analyzed using content analysis to identify themes, which are presented as assertions. Transcripts were re-analyzed to identify supporting and opposing instances of each assertion.
resultsA total of 15 themes emerged. There was wide variation in surgeons' described PME practices. Surgeons believed that PME improves surgical outcomes, but not all patients benefit. Surgeons were cognizant of the financial cost of the current system and the potential inconvenience that additional tests and office visits pose to patients. Surgeons believed that PME has minimal to no risk and that a normal PME is reassuring to them and patients. Surgeons were confident in their ability to assess surgical risk, and risk assessment by non-surgeons rarely affected their surgical decision-making. Hospital and anesthesiology requirements were a major driver of surgeons' PME practices. Surgeons did not receive much training on PME but perceived their practices to be similar to their colleagues. Surgeons believed that PME provides malpractice protection, welcomed standardization, and perceived there to be inadequate evidence to significantly change their current practice.
conclusionsViews of surgeons should be considered in future research on and reforms to the PME process.
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