Pledge to keep surgeons current on high-risk surgeries goes largely unanswered

A year after Johns Hopkins Hospital and Health System, Dartmouth-Hitchcock Medical Center and the University of Michigan Health System pledged that their surgeons must perform a certain number of high-risk surgical procedures to continue performing the procedures, no other hospital networks have joined them in the so-called volume pledge, according to The Washington Post.

Outcomes are poorer and mortality can be significantly higher when the high-risk surgical procedures are performed by surgeons and hospitals that don't do high volumes of the procedures, The Post reported. The 10 procedures include certain gastrointestinal, cardiovascular, and joint-replacement surgeries. Patients also are at a higher risk of death for common procedures performed at hospitals that do them infrequently, FierceHealthcare previously reported.

"There is this intractableness of patients undergoing surgical care in places that have no business doing it" or performed by what John Birkmeyer, chief academic officer at Dartmouth, called "hobbyist" surgeons who only occasionally perform the procedures.

"We decided to use volume as a pilot case, an initial foray into setting quality and safety standards," Birkmeyer told The Post. "And we wanted to do it in a way" that was not subject to the discretion of hospital officials.

Among the requirements of the pledge for surgeons, as reported by the newspaper: performing at least five pancreatic cancer surgeries per year in a hospital that does 20 such surgeries per year and 25 hip or knee replacements in a hospital that does at least 50 per year.

To learn more:
- read The Post article

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