|
Category
|
Examples
|
Equivalent Value
|
|
minor
|
wedge excision of nail, gastroscopy
|
0.5
|
|
intermediate
|
inguinal hernia, excision of breast lump
|
1.0
|
|
major
|
cholecystectomy, partial thyroidectomy
|
1.75
|
|
major plus
|
parotidectomy, colonic resection
|
2.20
|
|
complex major D
|
elective aortic aneurysm
|
3.10
|
|
complex major C
|
anterior resection of rectum
|
4.20
|
|
complex major B
|
ruptured aortic aneurysm, esophago-gastrectomy
|
5.25
|
|
complex major A
|
cardiac bypass surgery
|
6.33
|
from Table I, page 325
The workload for a surgeon for a given period can be calculated by:
(1) multiplying the number of procedures for each category performed by the equivalent value = ((number of procedures in category) * (equivalent value))
(2) summating across all of the categories.
Limitations:
• The scale has to be updated frequently to reflect changes in technology, such as newer laparoscopic techniques.
• While useful at the population level where variation tends to even out, individual cases at the same category may vary widely in complexity.
• This can be useful for comparing the workload between surgeons with a similar scope of practice. Comparing workload between different types of surgeons (for example, general surgeons versus and cardiovascular surgeon) can be misleading.
• Surgeons assisting another surgeon in a procedure tend to be underscored.
• As with any system, it can be gamed.
