The analysis of surgeons’ prescribing habits was done in collaboration with researchers at Johns Hopkins Bloomberg School of Public Health. To determine the average number of pills filled by patients within seven days of surgery, the analysis used Medicare claims data from 2011 to 2016, the most recent years available. Seven common procedures were considered: coronary artery bypass, minimally invasive gallbladder removal, lumpectomy, knee surgery, minimally invasive hysterectomy, open colectomy and prostatectomy.
For the six-year period from 2011 to 2016, and for each individual year, only surgeons who did more than 10 surgeries on Medicare patients who had not taken opioids in the prior year were included. Each surgeon’s average of pills per patient was calculated by dividing the total units of opioids filled using Medicare Part D by the total number of patients who filled them after a particular surgery. Units, referred to as “pills,” are each equivalent to a 5-milligram tablet of oxycodone. The surgeon does not necessarily write the prescription; it can be written by residents or other doctors. Some patients may have received prescriptions they did not fill, or that they filled using other insurance. Those prescriptions are not factored into this analysis.
Averages for each surgeon over the six-year period are available online at khn.org, searchable by physician name or affiliated hospital. Surgeons’ hospital affiliations are current as of May 2018 or the most recent data available before then.
Some surgeons listed in the database who were contacted by KHN expressed criticism, saying the analysis failed to take into account key factors.
For instance, like other studies that look at claims data, it was not possible to determine whether some patients had complications or needed higher amounts of pain medication for another reason. And some surgeons had only a handful of patients who filled prescriptions, making for a small sample size.