Economic Issues Impacting Surgical Care Delivery

Abstract

The economics of modern healthcare are at tremendous crossroads. Historically, our profession has focused primarily on caring for the patient; however, surgeons must now learn to balance the cost/quality ratio. Careful assessment of new technologies is required to reduce escalating cost, while avoiding the unnecessary waste of precious medical resources. Importantly, we must define complications not thru the impossible prism of a “never event,” but rather via implementation of proven advancements in clinical care and the appropriate management of complications when they do occur. In this paradigm, a global reduction in total cost of care achieved by safe earlier discharge would not be punished by the minimal impact of an unanticipated (and unavoidable) readmission. Unfortunately, in the face of this paradigm shift, many (if not most) surgeons lack a clear understanding of even the basics of financial structure as it relates to themselves, their local healthcare system, or the nation. My goal is to provide an overview of the topic of cost structure related to surgical practice and provide insight into how individual surgeon decision-making will ultimately impact the probability of success in both the clinical and financial arenas.