Surgeon experience and opioid prescribing

Background: We evaluated the effects of surgeon characteristics such as surgeon experience on differences in opioid prescribing after surgery. Methods: We evaluated a 20% national sample of Medicare beneficiaries >= 65 years old who underwent 15 different types of surgery to identify surgeon characteristics associated with opioid prescription size filled within seven days of discharge using a multi-level linear model. Results: 174,141 patients and 13,828 surgeons met inclusion criteria. 53.8% of patients filled an opioid prescription within seven days postoperatively. The amount of opioids prescribed after surgery was highest for patients whose surgeons were early in practice (i.e. 0-7 years in practice). Surgeon credentials, type of surgery, and geographic region were associated with differing sizes of opioid fills postoperatively. Conclusions: Surgeon characteristics such as cumulative years of practice contribute to differences in prescribing behavior after surgery. These findings can help develop strategic interventions to enhance opioid stewardship. (C) 2020 Elsevier Inc. All rights reserved.