Introduction: Surgical fields are becoming increasingly specialized. This can lead to misunderstanding or confusion about the scope of practice of different surgeons by the individual seeking specialized surgical care. To assess public understanding of subspecialty surgeons, we sought to survey general knowledge of the specialty areas of Endocrine Surgery and Vascular Surgery.
Methods: A survey was conducted in three locations in Birmingham, Alabama: a local farmers market, a public park, and the University of Alabama at Birmingham hospital. Fifty people were surveyed at random at each of the three locations, with hospital staff identified by wearing a hospital ID badge recruited at the University of Alabama at Birmingham hospital location. Participants were asked to define both an endocrine surgeon and vascular surgeon, as well as identify aspects of their practice. Participant's answers to the survey were recorded and coded by three evaluators (two MDs, one PharmD candidate). Survey responses were assessed for correct definition of the specialty (yes/no), recognition of being a surgeon (yes/no), spectrum of practice (none, partial, or complete), and presence of a common misconception (yes/no). Interrater reliability (kappa) was calculated for each question. Chi-square test was used to compare the difference in each answer between the two specialties.
Results: A total of 150 people participated in the study. The majority were female (58%) and approximately 50 y of age or less (65%). Interrater reliability from 0.32 to 0.84 was observed, and agreement from 40% to 98% between raters was achieved for all questions. Significantly more respondents recognized endocrine surgery as a surgical profession (21%) compared to vascular surgeons (18%) (P < 0.001). However, significantly fewer could define what an endocrine surgeon does (14%) than could define what a vascular surgeon does (57%). Only 3% of respondents could identify the entire spectrum of practice of an endocrine surgeon, with 42% and 55% providing partially or completely incorrect responses, respectively. Significantly more respondents could identify all of a vascular surgeon's spectrum of practice (11%), with 60% and 29% providing partial or completely incorrect responses, respectively (P < 0.001). Endocrine surgeons were most often confused for endocrinologists (40%), whereas vascular surgeons were most often confused for cardiovascular surgeons (22%).
Conclusions: This study reveals an overall lack of understanding among the general public about what endocrine and vascular surgeons are and their spectrum of practice and shows that public understanding of the field of endocrine surgery is very low. More efforts need to be made to increase the visibility of these fields and communicate these surgeons' specialized expertise.
Keywords: Endocrine surgery; Health literacy; Subspecialty surgery.
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