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According to an article recently published in the Journal of Clinical Oncology, patients with breast cancer who are involved in selecting their surgeon tend to choose surgeons with greater experience than women who are referred to a surgeon by another healthcare provider or healthcare plan.

Results from recent studies have indicated that patients with various types of cancer tend to have improved outcomes if treated by physicians who have performed a higher volume of very specific surgical procedures rather than by physicians who have performed lower volumes of the same procedure. In addition, results from recent studies have also indicated that patients treated at hospitals that have high volumes of patients undergoing a specific treatment or procedure tend to produce improved outcomes for certain types of cancers compared to hospitals without similar high volumes for the same treatment or procedure.

Researchers from several medical institutions in the United States recently conducted a clinical study to analyze referral pathways for patients and associated characteristics of surgeons and hospitals at which they are treated. In this study data from the Surveillance, Epidemiology, and End Results (SEER) registries in the Detroit and Los Angeles areas were analyzed. The data included 1,844 women who were diagnosed with breast cancer in 2002.

  • 54.3% of patients stated that they were referred to their surgeon by a different healthcare provider or healthcare plan.
  • 20.3% of patients stated that they had selected their surgeon.
  • 21.9% of patients stated that they were both referred to their surgeon and were involved in the selection of their surgeon.
  • Patients who selected their surgeon were more than twice as likely to choose a surgeon who had performed high-volumes of the procedure they were to receive; these patients were also twice as likely to be treated in a National Cancer Institute (NCI)-designated cancer center or in an American College of Surgeons-approved cancer program.
  • Patients who had been referred to their surgeon were half as likely to be treated in an NCI-designated cancer center.
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The researchers concluded that women who are involved in selecting their surgeon tend to choose surgeons who have performed high volumes of the procedure they are to receive and are more likely to be treated in NCI- or American College of Surgeons-designated cancer centers or programs. The authors state, “Patients shouldbe aware that provider or health plan–based referral may not connect them with the most experienced surgeon or comprehensive practice setting in their community.”

Reference: Katz S, Hofer T, Hawley S, et al. Patterns and correlates of patient referral to surgeons for treatment of breast cancer. Journal of Clinical Oncology. 2007; 25: 271-276.

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