In May of 2015, three well known medical centers took a pledge to eliminate the performance of certain procedures by surgeons who performed relatively few of those procedures. The campaign, called The Volume Pledge, received attention and sparked discussion. More recently, research has questioned whether there is some other useful, broadly applicable metric to predict surgical outcome. To that end, whether a surgeon specializes in a particular procedure, or group of procedures, is being explored as a marker for excellent outcome...independent of surgeon volume. Here's one study now:
surgeon specialization accounted for 9% (coronary artery bypass grafting) to 100% (cystectomy) of the relative risk reduction otherwise attributable to volume in that specific procedure. Conclusion For several common procedures, surgeon specialization was an important predictor of operative mortality independent of volume in that specific procedure. When selecting a surgeon, patients, referring physicians, and administrators assigning operative workload may want to consider a surgeon’s procedure specific volume as well as the degree to which a surgeon specializes in that procedure.