We commend Auffenberg et al1 on their prospective cohort study in this issue of JAMA Surgery on patient-reported outcomes of urinary continence following radical prostatectomy. They found that top-performing surgeons consistently achieved higher patient-reported continence, regardless of risk group (independent of patient population). Interestingly, experience as represented by case volume did not appear to play a role in improving outcomes.2 This implies that factors other than sheer volume play a role in determining who is a good surgeon. While most surgeons have an intuitive sense of what contributes to surgical skill, strategies to rigorously define and disseminate these characteristics will be critical in improving outcomes.
Han TX, Cole AP, Trinh Q. A New Era in Surgical Evaluation—What Is at Stake? JAMA Surg. 2021;156(3):e206360. doi:10.1001/jamasurg.2020.6360
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