Should Surgical Outcomes for Individual Surgeons Be Available to the Public?
In the 1980s, journalists used the Freedom of Information Act to obtain data on individual cardiac surgeons’ surgical outcomes from the New York State Department of Health. A recent JAMA article discusses that type of data and takes the position that despite its limitations, the data should be publicly reported.
Debate Surrounding Reporting of Individual Surgeons’ Outcomes
The debate centers on whether data should be reported on the hospital level only or also reported as to individual surgeons.
According to the article, several objections to reporting data relating to individual surgeons have been raised.
First, an individual surgeon may perform a low number of procedures, possibly leading to an unreliable measure of performance. However, the author notes that performance can be aggregated across multiple years or a surgeon’s performance across a range of procedures can be used. Also, the data can be presented in a way that highlights the statistical limitations.
Critics of naming individual surgeons also argue that surgeons may avoid hard cases as a result of public reporting. The author also notes that some surgeons have stopped practicing or moved away as a result of public reporting of individual surgeons’ outcomes. However, studies examining whether publicly reporting individual surgeon data leads to more seriously ill patients not receiving care have mostly failed to support that theory.
Opponents also argue that naming an individual surgeon fails to take the surgical team’s performance into account. However, the surgeon is the leader of the team and his or her role is overwhelmingly important in terms of decision-making, judgment and skill. In fact, the decision to perform surgery in individual circumstances falls primarily to the surgeon and reporting outcomes only at the institutional level would overlook that judgment-based decision.
Patients Need Surgeons’ Outcome Data to Make Informed Decisions
The author concludes that data on individual surgeons’ patient outcomes are important in the decision-making process when a patient is choosing a surgeon. It seems clear that data on individual surgeons is information that patients want. Studies have shown that there are differences in individual surgical capabilities. An individual surgeon’s skill is important to patients. Hospital-level data will not provide the information that patients seek to make an informed healthcare decision when choosing a surgeon.
Increasing efforts to report individual surgeons’ performance publicly is important to patients and vital to the overall goal of improving surgical care.