Photo Credit: XiXinXing
The following is a summary of “Characteristics and Practice Patterns of Non-Certified Surgeons Treating Medicare Patients,” published in the January 2025 issue of Surgery by Moreci et al.
This study aims to examine the patient demographics and practice patterns of non-certified surgeons who provide care to Medicare patients across the United States.
Although the majority of surgeons in the U.S. are board-certified, non-certified surgeons are still permitted to practice in many regions. Concurrently, shortages in the surgical workforce pose significant threats to patient access to necessary surgical care. Non-certified surgeons may play a critical role in addressing these access issues. However, limited information is available about the practice behaviors and patient populations served by non-certified surgeons.
Using a comprehensive dataset of Medicare claims from 2014 to 2019, this study identified practicing general surgeons, categorizing them as either board-certified or non-certified in general surgery, based on data from the American Board of Surgery. An analysis of surgeon practice patterns and patient characteristics was then conducted.
The study included data from 2,097,206 patient cases treated by 16,076 surgeons, of which 6% were non-certified. Compared to their certified counterparts, non-certified surgeons were less frequently fellowship-trained (20.5% vs. 24.2%, P=0.008) and more often foreign medical graduates (14.5% vs. 9.2%, P<0.001). Non-certified surgeons were more likely to practice in for-profit hospitals (21.2% vs. 14.2%, P<0.001) and critical access hospitals (2.2% vs. 1.3%, P<0.001) and were less commonly found in teaching hospitals (63.2% vs. 72.4%, P<0.001). Non-certified surgeons also treated a higher proportion of non-White patients (19.6% vs. 14%, P<0.001) and a greater percentage of patients from the two lowest socioeconomic status quintiles (36.2% vs. 29.2%, P<0.001). Emergency admissions were more prevalent in operations performed by non-certified surgeons (68.8% vs. 55.7%, P<0.001). There were no significant differences in the sex or age of patients treated by certified and non-certified surgeons.
Among Medicare patients, non-certified surgeons predominantly cared for more non-White patients, individuals of lower socioeconomic status, and those in rural or critical-access hospitals. These findings suggest that non-certified surgeons may be essential in providing care to underserved populations, potentially helping to mitigate disparities in access to surgical services.
