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Invited Commentary
March 18, 2020

Protecting Patients and Our Profession

Author Affiliations
  • 1Department of Surgery, Center for Surgery and Health Economics, Perelman School of Medicine, Philadelphia, Pennsylvania
  • 2Departments of Pediatrics and Health Policy; Center for Patient and Professional Advocacy, Vanderbilt University Medical Center, Nashville, Tennessee
JAMA Surg. Published online March 18, 2020. doi:10.1001/jamasurg.2020.0108

In surgery, unprofessional behaviors have been shown to affect team and individual performance and result in greater risk for surgical complications and malpractice claims.1-4 Until now, there have been limited data to support early-career identification of surgeons at risk of unprofessional practices, which could guide potential prevention efforts. In this issue of JAMA Surgery, Kopp et al5 assessed the association between American Board of Surgery examination performance and subsequent severe medical license disciplinary action for 44 290 surgeons who applied for certification between 1976 and 2017 using linked data from the American Board of Surgery and state medical licensure boards. Surgeons who failed to obtain certification had a 3-fold increased risk of later severe disciplinary action compared with surgeons who obtained certification (hazard ratio, 3.38; 95% CI, 2.79-4.10). Interestingly, surgeons who failed either or both the written qualifying (QE) or oral certifying (CE) examination at least 1 time (32% of the cohort) were all at significant risk for subsequent severe disciplinary action even if they passed a repeated examination.

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