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Correspondence and Brief Communications |

Longer Surgical Durations Can Lead to Significant Staffing Costs to the Anesthesiology Department and Hospital

Amr E. Abouleish, MD, MBA
Arch Surg. 2005;140(2):212. doi:10.1001/archsurg.140.2.212-a.
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I read with great interest the report by Babineau et al1 on the cost of surgical residents. I agree with the authors that surgical residents by definition should take longer than fully trained surgeons to complete a surgical procedure. On the other hand, I must disagree with their conclusion that the costs to the hospital or anesthesiology department are insignificant.

I agree with the authors’ argument that staffing costs are fixed during regular hours and that a decrease in a small time period in one operating room will not decrease staffing costs, but I must point out that this is a decrease in time during regular hours. I must disagree with the authors’ conclusion that this fixed-cost argument leads to no increased staffing costs to the hospital or anesthesiology group. Two items need to be considered. First, if the operating room is being staffed by personnel working “overtime” that is not a scheduled shift (eg, late cases in evening hours), then a reduction in surgical duration that leads to a reduction in overtime will result in a reduction in staffing costs.2 In addition, longer surgical duration may also account for increased fixed costs due to a larger number of operating rooms.2,3

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