Residents assisting with your surgery can save lives, but at a cost

When undergoing surgery, would you want interns and residents present, and perhaps, assisting in the operation?

That’s a question patients face when going to an academic medical center.  Some won’t mind the presence of house staff.  Some will.

A recent study provides some details on the outcomes.

In a column by Pauline Chen in the New York Times’ Well blog, she notes that,

The Journal of the American College of Surgeons published the results of a study on how well patients come through when a surgeon-in-training is involved in the operation. Analyzing the results of more than 600,000 operations at more than 225 hospitals across the country, researchers found that while resident involvement was indeed associated with slightly higher complication rates and longer operating times, those patients who had trainees participating in their operations also experienced decreased mortality rates.

So the question becomes, would patients rather have a slightly higher chance of a minor complication, in exchange for a slightly improved mortality rate?

Or, as the lead author puts it, “Would you accept the risk of a urinary tract infection that required an antibiotic for several days if you knew it might save your life?”

It’s unclear why having interns and residents present decreases mortality. One hypothesis is that having a team present can prevent the cascading “domino” effect of progressively worsening complications, rather than a single surgeon.

Another could be that more eyes on the patient can catch potential medical errors.

The downside, of course, is that residents involved in the procedure won’t be as technically accomplished, thus leading to a higher complication rate.

The ultimate decision is in the hands of the patient. Now, armed with this data, they can make better informed decisions whether they want residents and interns involved with their surgical procedure.

 is an internal medicine physician and on the Board of Contributors at USA Today.  He is founder and editor of KevinMD.com, also on FacebookTwitterGoogle+, and LinkedIn.

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