M. Klingensmith1, T. H. Cogbill3, K. Samonte2, A. Jones2, M. Malangoni2 1Washington University,Surgery,St. Louis, MO, USA 2American Board Of Surgery Inc,Philadelphia, PA, USA 3Gundersen Health System,Surgery,LaCrosse, WI, USA
Introduction: Practice administration education and experience during surgery residency is limited and highly variable among residency programs. To gain understanding into the current status of practice administration training, a survey of recent General Surgery residency (GS) graduates was undertaken. This was compared to results from a survey of GS program directors (PD).
Methods: All US allopathic GS graduates who completed residency from 2009- 2013 (n= 5194) were anonymously surveyed by the American Board of Surgery (ABS) to assess opinions regarding their desire to have received more instruction and experience during residency in the following practice administration areas: coding, contract negotiations, practice management, insurance billing, billing the uninsured, liability, insurance for one’s own practice, and retirement planning. Surveys were distributed by mail in November 2013 with up to two follow up mailings to non-respondents. General Surgeons were defined as those who did not pursue fellowship training; specialist surgeons (SS) completed additional training following GS residency. Separately, all GS residency PDs were surveyed regarding the inclusion of practice administration education in their residency programs.
Results: There were 3354 respondents to the GS graduate survey (response rate 68%). GS comprised 876 of the total respondents (26%) with SS accounting for the remaining 74%. The vast majority of all respondents desired more training in all areas of practice administration that were queried: coding instruction (desired by 86%), contract negotiations (84%), practice management (83%), insurance billing (82%), billing those uninsured (77%), liability (76%), insurance for one’s own practice (75%), and retirement planning (72%). There were no significant differences in the degree to which these areas of instruction were desired among graduate year cohorts, residency program type or current practice setting (academic vs community). However, GS tended to have greater desire for this training than SS in many but not all content areas queried. The GS PD survey had a response rate of 68% (171 of 252 programs). Among respondents, only 28% of programs included practice administration as part of the residency curriculum.
Conclusion:
Despite increased accreditation and ABS requirements for GS residency programs, there is no mandate for trainees to receive practice administration education and this topic is seldom included in the curriculum. However, such skills are highly desired and needed by program graduates in a range of practice types and locations. This large survey of recent GS residency graduates indicates a clear and desired need for an improved curriculum and experience in practice administration topics during residency. Steps should be taken to address this educational gap.