Utilization of Surgical Manpower in a Prepaid Group Practice

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Abstract
To study the utilization of surgeons in a prepaid group setting, the operative work loads, of seven general surgeons comprising the general surgical staff of a prepaid group practice of 158,000 enrollees were determined. The median weekly work load, 9.9 hernia equivalents per week, was over three times that of a previously studied population of 19 general surgeons in fee-for-service community practice (3.1 hernia equivalents) and approximated a previously elaborated consensus standard of a full weekly surgical work load (10 hernia equivalents). The median complexity of inpatient, ambulatory and all operations was 1.14, 0.16, and 1.00 hernia equivalents, respectively. Evidence suggested that the most complex operations were handled by the most highly trained surgeons; 23.8 per cent of operations were performed on an ambulatory basis. The results suggest that the prepaid group practice under study is able to utilize efficiently both general surgeons and the resources devoted to general surgery. (N Engl J Med 291:759–763, 1974)

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