Given the inherent risk in surgical intervention and the need for the optimal utilization of health care resources, achieving high-quality surgical care is a priority for the American health care system, and competent surgeons are critical to reaching this goal. Despite the multifactorial nature of patient safety and satisfaction, surgeon competence is often oversimplified to an assessment of volume because of the ease of collection and comparison. In any practice model, the analysis of competence is complex, but the components of clinical skill for military surgeons further include multiple areas of expertise, which, although superficially unrelated to surgical currency, augment the overall care delivered by these clinicians. Thus, volume as a solitary indicator of skill excludes the unique circumstances encompassed in military service. In this paper, the factors comprising volume and competence are explained, as well as the additional factors unique to military medicine. Furthermore, process improvements are proposed for assessing and optimizing surgical competence in the Military Health System.

中文翻译：

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手术量与能力的关系：何时足够，足够？

鉴于手术干预的固有风险和最佳利用医疗保健资源的需求，实现高质量的手术护理是美国医疗保健系统的首要任务，而称职的外科医生对于实现这一目标至关重要。尽管患者安全和满意度是多因素的，但由于易于收集和比较，外科医生的能力通常被过度简化为体积评估。在任何实践模型中，能力分析都是复杂的，但军事外科医生临床技能的组成部分还包括多个专业领域，虽然表面上与手术货币无关，但这些领域增强了这些临床医生提供的整体护理。因此，数量作为技能的唯一指标不包括服兵役中包含的独特情况。在本文中，解释了包括数量和能力在内的因素，以及军事医学特有的其他因素。此外，还提出了用于评估和优化军事卫生系统中的手术能力的流程改进。