Accumulating a Portfolio of Experience: The Effect of Focal and Related Experience on Surgeon Performance

One key driver of improvement in surgical outcomes is a surgeon's prior experience. However, research notes that not all experience provides equal value for performance. How, then, should surgeons accumulate experience to improve quality outcomes? In this paper, we investigate the differential effects of focal and related (i.e., tasks similar to, but not identical to, the focal task) experience. We open up the black box of the volume-outcome relationship by going beyond just dividing experience into focal and related categories, but also considering how subtasks and context (i.e., the organization in which the work takes place) affect performance. To understand these issues, we assemble a novel data set on 71 cardiothoracic surgeons who performed more than 6,500 procedures during a period of 10 years after the introduction of a breakthrough surgical procedure. We find that, as compared to related experience, surgeon focal experience has a greater effect on surgeon performance. We also demonstrate that subtask experience has different, nonlinear performance relationships for focal and related experience. Finally, we find that focal experience is more firm specific than related experience and that nonfirm experience reduces the learning rate for both focal and related experience. We discuss implications of our findings for healthcare delivery and operations management.