Value-Based Shoulder Care: Volume vs Value
Dear Fellow Codman Shoulder Society (C.S.S.) Members:
The first, by Weinheimer and colleagues, “Patient Outcomes as a Function of Shoulder Surgeon Volume: A systematic review”, is a meta-analysis of the literature on total shoulder arthroplasty and rotator cuff repair. It concludes that surgeon volume (experience) is a major factor for surgical complications and cost of care. This confirms what Higgins and coauthors, as well as others, have already shown previously.
The second article is a commentary authored by Dr. Laurence D. Higgins and myself entitled “Volume and Outcome: One Hundred Years of Perspective on Value from EA Codman to ME Porter.” Not surprisingly, these great leaders in value-based care have the same perspective on the impact of surgeon experience on value for the patient, the hospital, the insurer, and society. Most importantly, they both share a commitment to measure outcomes and thus improve as a method to improve value for patients. It is particularly interesting to compare shoulder care to cardiothoracic surgery (CTS) as the commitment to measurement and improve in CTS is the standard to which we shoulder surgeons should aspire.
I would like to thank Michael E. Porter , Robert Kaplan, and David Shahian for their assistance with our commentary.
Jon J.P. Warner, MD & Laurence D. Higgins, MD, MBA