Surgeries are extremely expensive (exceeding a hundred thousand dollars for a spinal fusion, for instance), and most surgeons have little knowledge of their OR costs. We hypothesize that we can lower surgical costs by creating a price transparency initiative. When presented with cost data, surgeons may choose cheaper alternatives, and may choose to forgo expensive tests with very low yields. For instance, a neurosurgeon may choose a cheaper craniotomy plating set, or may decide to forgo a post-operative CT scan in a neurologically intact patient, when presented with the “bill”.

We believe that this approach is particularly promising because it empowers surgeons (who are very independent thinkers) to make their own decisions regarding resource utilization when given the appropriate information. In the past, surgeons have been resistant to using non-brand name hardware or cheaper items when forced to do so, but our approach lets the surgeons choose what they want to use both in and outside the operating room.

We will prospectively collect total OR costs at UCSF and provide surgeons with feedback on a weekly basis about their surgical costs, including the biggest drivers of cost, such as implants and devices. We will also compare surgeons to their peers and to historical cost data. For the largest drivers of cost, we will specifically cite alternatives, with exact prices. Eventually, our goal is to develop software to automate this process.

We believe that providing surgeons with real-time cost information will allow them to make better decisions in terms of resource utilization that lead to decreased OR costs. If needed, we may also develop financial or other motivations to incentivize this process.