Outcomes of physician patients after non-cardiac surgery: a registry analysis

J Anesth. 2017 Feb;31(1):111-119. doi: 10.1007/s00540-016-2273-3. Epub 2016 Oct 31.

Abstract

Objectives: When physicians become patients, they may expect special privileges, extra attention from caregivers, and non-routine treatments. Consequently, physician patients may not be treated per routine-which possibly worsens care rather than improving it. We thus tested the primary hypothesis that in-hospital mortality and major complications after non-cardiac surgery are more common in physician patients than in non-physician patients.

Patients and methods: Perioperative data were extracted for patients who had non-cardiac surgery at the Cleveland Clinic between 2005 and 2013. We used propensity score matching to identify comparable groups of physician and non-physician patients. Matched physician and non-physician patients were compared on a composite of in-hospital mortality and major postoperative complications using a generalized equation average relative effects model. Secondly, the matched patients were also compared on reoperation using logistic regression and on duration of hospitalization using Kaplan-Meier analysis with the log-rank test and Cox proportional hazards regression.

Results: Among 21,173 qualifying patients, we matched 522 physician patients to 2448 non-physician controls. There were no significant differences between physician and non-physician patients in the composite of in-hospital mortality and major complications, with an estimated odds ratio across the outcome components (average relative effect) of 1.20 (95% confidence interval 0.77-1.87) for physicians vs. non-physicians, P = 0.41. There was also no difference in the risk of re-operation or duration of hospitalization.

Conclusions: A variety of important outcomes were similar in physician patients and matched non-physician patients after non-cardiac surgery.

Keywords: Anesthesia; Health services; Mortality; Physician patient; Surgery; Visiting important person.

MeSH terms

  • Adult
  • Aged
  • Female
  • Hospital Mortality
  • Hospitalization / statistics & numerical data*
  • Humans
  • Kaplan-Meier Estimate
  • Logistic Models
  • Male
  • Middle Aged
  • Odds Ratio
  • Physicians / statistics & numerical data*
  • Postoperative Complications / epidemiology*
  • Registries
  • Reoperation / statistics & numerical data