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How do you choose your surgeon if you need an operation? One question to ask is how many operations surgeon does each year. But is that a real indicator of quality? How do you choose your surgeon if you need an operation? What are the right questions to ask? One variable that receives attention is volume. How many of these operations does the surgeon do a year? And how accustomed to the operation is the hospital? Well, it depends on the operation. The more major and the higher the risk, the more important volume becomes. But the trouble is that no-one's too sure what the numbers are between safe and less safe, for either surgeon or hospital. And what about smaller operations? A Swedish group has studied groin hernia repairs, comparing the effect of volume on the chances of needing a repeat procedure. They found that the cut-off was five hernia repairs a year. Beyond that, additional numbers made little difference. So volume wasn't a big part of the story, and the overall impact of low-volume surgeons depended on how many of them there were and what proportion of hernia surgery they did. So with hernias at least, you're probably stuck with asking the surgeon what their wound infection and re-operation rates are, compared to the average of their colleagues. A good surgeon will take such a question with aplomb. A defensive response might suggest that a second opinion is in order.
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