COMMENTARY

'We Need to Raise the Bar' on Prostate Surgeries

High-Volume Surgeons and Hospitals May Have Better Track Records

Andrew J. Vickers, DPhil; Matthew R. Cooperberg, MD, MPH

Disclosures

May 24, 2013

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In This Article

Andrew J. Vickers, DPhil: Hi. I am Dr. Andrew Vickers from Memorial Sloan-Kettering Cancer Center in New York. Today I am in San Diego at the 2013 Annual Scientific Meeting of the American Urological Association (AUA). Joining me is Dr. Matt Cooperberg, who is a urologic surgeon specializing in cancer and oncology at the University of California in San Francisco.

We work in very complementary areas. I am a statistician, and one thing I have studied is the effect of surgeons on patient outcomes. Last evening, I learned that you used to play the saxophone.

Matthew R. Cooperberg, MD, MPH: A little bit, a long time ago.

Dr. Vickers: You were learning the saxophone while learning to be a surgeon. Is there a connection there?

Dr. Cooperberg: I think that if I had to put the commitment into saxophone that I had to put into becoming a surgeon, I would probably be in a different place today. There is no question that both involve a lot of practice, acquiring skills, and then practicing them over and over until you do it well, continually learning to do it better. There are certainly a lot of parallels in learning to play an instrument and learning to be a good surgeon.

Dr. Vickers: You mentioned continuing to practice.

Dr. Cooperberg: Absolutely.

Dr. Vickers: But our current model for surgery is a bit like driving: You learn to drive, you pass your test, and then you can pretty much do whatever you want. That is roughly how it is with surgery, would you agree?

Dr. Cooperberg: I think that was definitely true up until at least the past few years. With the increasing emphasis on maintaining certification, continuing medical education, and a variety of these medical team training exercises that hospitals implement, however, the model is changing to more of a continuous education process. That applies to certification as well. But from the standpoint of receiving hospital admitting privileges and, ultimately, in terms of who is allowed to perform an operation, that is usually up to local hospitals, and that process is typically a one-time certification.

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