To the Editor While the use of National Surgical Quality Improvement Program (NSQIP) data by Childers et al1 is a welcome attempt to objectively gauge the workload of specialists, the methods are oversimplistic. Adjusting for length of procedure, hospital stay, and readmissions might work well for comparing workload between procedures within a given specialty, but this falls short when it comes to interspecialty comparisons. The authors concede in the Methods section1 that they could not find a reliable objective measure of complexity, so they settled with 30-day reoperation rate as a surrogate.
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Bakaeen FG, Roselli EE, Svensson LG. Varying Estimations of Surgical Work Value Units. JAMA Surg. Published online November 20, 2019. doi:https://doi.org/10.1001/jamasurg.2019.4632
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