The news site ProPublica has posted a major new report about surgical complications and the relative effectiveness of individual surgeons in avoiding them. The report is based on data collected by Medicare on the performance of nearly 17,000 surgeons nationwide, and the results are interesting to say the least.
The most surprising finding is how just a few doctors were responsible for so many of the surgical complications—and that individual facilities and hospitals were a less important factor. From the ProPublica article:
It’s conventional wisdom that there are “good” and “bad” hospitals — and that selecting a good one can protect patients from the kinds of medical errors that injure or kill hundreds of thousands of Americans each year. But a ProPublica analysis of Medicare data found that, when it comes to elective operations, it is much more important to pick the right surgeon.
A small share of doctors, 11 percent, accounted for about 25 percent of the complications. Hundreds of surgeons across the country had rates double and triple the national average. Every day, surgeons with the highest complication rates in our analysis are performing operations in hospitals nationwide.
The report is quick to say that it’s not really a “bad apple” problem, with individual doctors acting intentionally to harm patients. Rather, the report speaks to systemic failures in processes, procedures and conditions that make it more likely doctors and other healthcare workers will make mistakes before, during and after surgery.
All in all, this report underscores how important it is to look at the performance record of individual surgeons before undergoing elective surgery. But the problem is (as my colleagues have written about in prior blogs), it is very difficult for the public to access this kind of data easily, if at all. That’s why this ProPublica investigation, as limited as it is, is such an important addition to the conversation about overall patient safety.
So, where does that leave us patients? What should we do to ensure we’re entrusting our care to the best surgical team possible?
First and foremost, whenever possible, get a second opinion, especially before any elective procedures. It’s amazing how many complications arise from procedures that aren’t strictly necessary in the first place.
Also, there generally isn’t much detailed information about the performance of individual doctors. However, information can be found on the websites of each state’s physician licensing board. In Maryland, you can find that information here: www.mbp.state.md.us. As well, a simple Internet search of your doctor’s name will lead you to sites which will provide important background and other information.