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Ann Thorac Surg 1996;61:12-16
© 1996 The Society of Thoracic Surgeons

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Original Articles: Cardiovascular

Volume Requirements for Cardiac Surgery Credentialing: A Critical Examination

Medical University of South Carolina, Charleston, South Carolina, Virginia Mason Clinic, Seattle, Washington, Medical College of Pennsylvania, Pittsburgh, Pennsylvania, University of Colorado Health Sciences Center, Denver, Colorado, Washington University School of Medicine, St. Louis, Missouri, Pennsylvania State University, Hershey, Pennsylvania, and University of North Carolina, Chapel Hill, North Carolina

Accepted for publication October 26, 1995.

New volume requirements for coronary artery bypass grafting are being imposed on cardiac surgeons by hospitals, managed care groups, and others. The rationale for this is unclear. The available literature as well as additional sources relating volume and outcomes in cardiac surgery were extensively reviewed and reexamined. There are no data to conclusively indicate that outcomes of cardiac operations are related to a specific minimum number of cases performed annually by a cardiac surgeon. Each cardiothoracic surgeon should participate in a national database that permits comparison of his or her outcomes on a risk-adjusted basis with other surgeons. Until conclusive data become available that link volume to outcome, volume should not be used as a criterion for credentialing of cardiac surgeons by hospitals, managed care groups, or others. Instead, each surgeon should be evaluated on his or her individual results.

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