Surgeons need to enhance teamwork with anesthesiologists to improve patient safety and outcomes in the OR.

• Interviews with 40 surgeons and anesthesiologists revealed seven barriers to collaboration, including communication issues and professional identity conflicts.
• Five effective strategies were identified: fostering relationships, improving communication at all surgical phases, and adopting a mindset of respect and trust.

Actionable insights from this study can help surgeons build better working relationships, ultimately benefiting patient care and safety.

• Methods like early case discussions and frequent updates can strengthen collaboration in real-time.

Surgeons should note that operating in high-markup hospitals significantly raises patient risks and costs for major surgeries.

• Patients at high-markup hospitals faced 50.3% higher costs and increased odds of in-hospital complications (adjusted odds ratio 1.07).
• Moderate-markup hospitals showed 24.7% higher costs and elevated mortality risks (adjusted odds ratio 1.07).

Surgeons must consider hospital pricing when evaluating surgical options, as care quality and costs vary dramatically.

• High-markup hospitals tend to be larger, urban, and for-profit, impacting patient outcomes and financial accessibility.

Switching to a global budget revenue model can enhance surgical outcomes for cancer procedures.

• Textbook outcomes improved from 72.8% to 76.1% in GBR hospitals versus a slight change from 70.2% to 70.5% in controls, showing a 2.9 percentage point gain (p=0.02).
• Complication rates fell by 1.5 percentage points, and prolonged stays decreased by 1.8 percentage points at GBR hospitals.

This approach also reduced Medicare spending by an average of $771 per patient.

• GBR participation could inform patient selection and hospital strategy to optimize surgical care and costs.