Society For Clinical Vascular Surgery

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The Financial Value of Vascular Surgeons as Operative Consultants to Other Surgical Specialties
Cali E. Johnson, MD, Miguel F. Manzur, MD, Todd A. Wilson, MBA, Fred A. Weaver, MD, MMM.
University of Southern California, Los Angeles, CA, USA.

OBJECTIVES: Vascular surgeons (VS) provide assistance to other surgical specialties (OSS) through planned and unplanned joint operative cases. The financial impact of VS as consultants in this context has not been quantified. We sought to quantify the financial value of services provided by VS to OSS in the performance of joint operative procedures, both planned and unplanned.
METHODS: Hospital financial data was reviewed for all inpatient operative cases over a 3-year period (2013-2015). Operative services provided by VS to OSS were identified and designated as planned or unplanned. Contribution margin (CM), defined as hospital revenue minus variable cost, was determined for each case, and CM ratio (CM divided by revenue) determined. Financial data for OSS cases involving VS was compared to all OSS cases not involving VS. Data analysis was performed with non-parametric statistics.
RESULTS: There were 208 OSS cases involving VS during the study period, 169 planned and 39 unplanned. 19,594 OSS cases without VS were identified for comparison. The median CM was higher for OSS cases with VS compared to OSS without VS ($14,406: interquartile range (IQR) $63,192, vs $5491: IQR $28,590; P .001). The overall CM ratio was higher for OSS with VS, 0.41, compared to OSS cases without VS, 0.35. There was no difference in CM and CM ratio between planned and unplanned OSS cases with VS.
CONCLUSIONS: Vascular surgeons frequently provide operative assistance to other surgical specialties. This operative assistance is frequent and provides significant financial value, with high CM and CM ratio. Vascular surgeons as operative consultants are financially advantageous to other surgical subspecialties and the hospital.

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