Organization Releases Ratings of Surgeons
The Consumers’ Checkbook/Center for the Study of Services recently released a listing of ratings of surgeons throughout the United States. The ratings looked at 14 of the more major surgeries that occur on a regular basis. These included everything from heart-valve replacement to major bowel surgery.
You can view the surgeon ratings at the following link: http://www.checkbook.org/surgeonratings/
The surgeons were rated on a few criteria. The amount of patient deaths were included as well as the number of surgical complications. Complications were measured by the amount of patients that had to stay in the hospital for an extended period following surgery.
For the top ten percent of of surgeons that the study looked at, mortality rates for heart valve replacement and bypass surgeries were less than 3%. For the bottom ten percent of surgeons, the mortality rate for those same procedures was around 11%.
Another patient safety organization, ProPublica, released similar ratings. They took a different approach to measuring surgeons. Rather than looking at more major surgeries, they analyzed procedures that take place everyday and that do not have high rates of incidence. This class of surgeries was mostly The study looked at the following 8 surgeries:
- Hip Replacement
- Knee Replacement
- Gallbladder Removal
- Lumbar Spinal Fusion, Posterior Column
- Lumbar Spinal Fusion, Anterior Column
- Prostate Resection
- Prostate Removal
- Cervical (neck) Spinal Fusion
Rather than looking at mortality rates, ProPublica focused primarily on smaller complications that could result from surgery. These complications included blood clots, infections, and uncontrollable bleeding. ProPublica did not look at hospitals as Consumers Checkbook did. They stated on their website, “Even within good hospitals, performance between surgeons can vary significantly.”
Not Everyone is Happy These Rankings Were Published
The American Academy of Orthopaedic Surgeons has expressed frustration with the way in which the ratings were compiled. They believe that the system that ProPublica used did not take into account the many variables that go along with surgery. The Academy stated they are committed to ending all surgical error but did not believe that this style of rating system was the best option for doing so.
The American Medical Association believes that releasing ratings of this nature can do a lot of harm. They argue that inaccurate ratings can greatly damage the trust felt between a patient and their physician.
But Some Feel That Rankings Like This Can Do A Lot of Good for the Surgical Community
Dr. Paul Wetter, chariman of the Society of Laparoendoscopic Surgeons believes that the release of these ratings could not have come at a better time. He believes that solutions are readily available for ending a lot of the surgical error that occurs.
Wetter argues that the manner in which pilots are trained in the airline industry should provide a model for surgeons. Pilots are forced to undergo hundreds of repetitions of the most unlikely of occurrences. Many pilots will never face the scenarios that they experienced during simulations.
Wetter cites the case of Chelsey Sullenburger who was able to successfully save the lives of over 150 people after one of his engines went out. Although he had never faced that situation in real life and would never do so again, the hundreds of repetitions he had went through during simulations allowed him to react instantly and without thinking.
Wetter believes simulations and training of this nature should be more prevalent for surgeons. He believes it could help save thousands of lives and allow for more numerous and successful surgieries.
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