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Variation in Spine Surgeon Selection Criteria Between Neurosurgery and Orthopedic Surgery Patients

Hijji, Fady, Y., MD*; Narain, Ankur, S., BA*; Haws, Brittany, E., BS*; Witiw, Christopher, D., MD†,‡; Kudaravalli, Krishna, T., BS*; Yom, Kelly, H., BA*; Deutsch, Harel, MD; Singh, Kern, MD*

doi: 10.1097/BSD.0000000000000576
PRIMARY RESEARCH
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Study Design: A cross-sectional survey study.

Objective: The objective of this study is to determine if there are any differences in spine surgeon selection criteria between neurosurgery patients and orthopedic patients.

Background Information: The evolution of the health care delivery system has allowed for increased patient autonomy in provider selection. However, the process and criteria by which patients choose particular spine surgeons is not well understood. Furthermore, differences in physician selection criteria used by patients who present either to a neurosurgery or orthopedic spine surgeon has not been previously established.

Materials and Methods: An anonymous questionnaire consisting of 26 questions was administered to 644 patients seeking treatment from either a single neurosurgery-trained or orthopedics-trained spine surgeon at an urban institution. Four questions pertained to demographic variables. Sixteen questions asked patients to rate specific spine surgeon selection criteria in terms of importance (scale, 1–10). Six questions were multiple choice, asking patients to select their preferences towards aspects of a spine surgeon. Patient responses were compared using χ2 analysis or Fisher exact test for categorical variables.

Results: The 3 most important factors for selecting a spine surgeon were the same for neurosurgery and orthopedic surgery patients: board certification (neurosurgery, orthopedic surgery) (9.07±2.35, 9.22±1.79), in-network provider status (8.01±3.15, 8.09±3.03), and surgeon bedside manner (7.88±2.52, 8.07±2.29). When listing their preference regarding surgeon specialty training, 82.74% of neurosurgery patients and 48.81% of orthopedic surgery patients preferred a surgeon who was trained in neurosurgery.

Conclusions: The growth in patient autonomy within the current health care system has emphasized the importance of identifying patient preferences in the physician selection process.

Board certification, in-network insurance status, and bedside manner may be the most influential factors for patients in spine surgeon selection irrespective of surgical subspecialty. Patients may also be more likely to seek spine surgeons with neurosurgery training over orthopedic surgery training. The present study provides spine surgeons a framework to improve both patient recruitment and patient satisfaction.

*Department of Orthopaedic Surgery

Department of Neurologic Surgery, Rush University Medical Center, Chicago, IL

Division of Neurosurgery, Department of Surgery, University of Toronto, Toronto, ON, Canada

The authors declare no conflict of interest.

Reprints: Kern Singh, MD, Department of Orthopaedic Surgery, Rush University Medical Center, 1611 W. Harrison St, Suite #300, Chicago, IL 60612 (e-mail: kern.singh@rushortho.com).

Received March 3, 2017

Accepted July 4, 2017

© 2018 by Lippincott Williams & Wilkins, Inc.