The surgery your doctor shouldn’t perform

A growing body of medical literature suggests that only highly trained vascular surgeons should, in the majority of cases, be allowed to perform the surgery. Because it requires the surgeon to close down a section of the aorta — akin to replacing a fuel hose in a plane at 30,000 feet — it has a relatively high mortality rate.

But despite a growing cry by vascular specialists to limit general surgeons’ ability to perform the abdominal aortic aneurysm surgeries, no such potentially life-saving restrictions are planned in the short-term.

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The overall mortality rate from abdominal aortic aneurysm surgeries averages about 5 percent. But when general surgeons perform the surgery, the mortality rate is 76 percent higher than when vascular surgeons do it, according to a recent University of Michigan/Johns Hopkins study of 3,912 cases. Other studies have reached similar findings.

This article makes some very important points. As a generalist, I know that one of my obligations to patients is to understand the limits of my expertise. If I rarely take care of a problem, then I need a consultant (SLE, interstitial lung disease, inflammatory bowel disease are but a few examples). General surgeons should understand their limitations. As I read the article, apparently many surgeons do not understand.