VOLUME REQUIREMENTS FOR CARDIAC-SURGERY CREDENTIALING - A CRITICAL-EXAMINATION

New volume requirements for coronary artery bypass grafting are being imposed on cardiac surgeons by hospitals, managed care groups, and oth ers. The rationale for this is unclear. The available literature as we ll as additional sources relating volume and outcomes in cardiac surge ry were extensively reviewed and reexamined. There are no data to conc lusively indicate that outcomes of cardiac operations are related to a specific minimum number of cases performed annually by a cardiac surg eon. Each cardiothoracic surgeon should participate in a national data base that permits comparison of his or her outcomes on a risk-adjusted basis with other surgeons. Until conclusive data become available tha t 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 ind ividual results.