L. Ferro1, E. Grenn2, C. Muncie2, D. Parrish1,2, L. Boomer1 1VCU Medical Center,Surgery,Richmond, VA, USA 2University Of Mississippi Medical Center,Surgery,Jackson, MS, USA
Introduction: The General Surgery Milestone Project was instituted by the Accreditation Council for Graduate Medical Education (ACGME) in 2015 as a new way to evaluate general surgery residents in their development into independent physicians based on six core competencies. One of these competency areas focuses on “System-Based Practice.” We hypothesized that resident cost knowledge and cost comparisons of various hospital services is poor, and this lack of knowledge affects their competency in regards to some portions of system-based practice.
Methods: The billing departments of two major academic institutions were queried regarding the charges for specific hospital services (cardiology consult, computed tomography (CT) scan of abdomen/pelvis, chest radiograph (CXR), stat complete blood count (CBC), magnetic resonance imaging (MRI) of the cervical spine, magnetic resonance cholangiopancreatography (MRCP), Hepatobiliary Iminodiacetic acid (HIDA), and right upper quadrant ultrasound). In an attempt to keep things standard, the costs were evaluated for uninsured patients. Once these costs were obtained, the general surgery residents were asked in an open ended survey the costs of each of these services. The residents’ responses were grouped and analyzed as a whole.
Results: Fifty-eight general surgery residents (83%) responded to the survey. The data was first evaluated to identify how many respondents could identify the cost of the service within 25% of the actual cost. The percent of residents that were able to name the cost of the service was low throughout (1.7% to 27.5% depending on service), with <10% of respondents being within 25% of the actual cost for cardiology consult, CXR, and CT scan of the abdomen and pelvis. When the data was evaluated to see if respondents could come within 50% of the actual cost, the results were improved (6.9% to 53.4%).
Conclusion: The results show a significant lack of knowledge of the costs of hospital services among general surgery residents. We believe that increased education in this area would benefit residents as they progress through their training and into their practices. This improvement in resident knowledge may also lead to cost-savings for both patients and hospitals.
