Surgeon Scorecard Brings Much-Needed Transparency to Healthcare

Conventional wisdom maintains that, just as there are good and bad schools and school districts, there are also good and bad hospitals. Funding from insurance, grants, Medicare, and Medicaid along with patient quality of care reports are the most relied upon—though not necessarily the most reliable—metrics to determine which hospitals are the "best" and which are the "worst." But just as the RAND Corporation has shown that individual teachers have a larger impact on students' growth (or lack thereof) than their schools, mounting research in medical complication rates has indicated that individual surgeons and other practitioners can have a commensurably substantial impact on patient outcomes.

ProPublica stands at the forefront of this movement, claiming in a recent article that their "analysis of Medicare data found that, when it comes to elective operations, it is much more important to pick the right surgeon" than the right hospital. ProPublica recently announced that they were "making public the complication rates of nearly 17,000 surgeons nationwide," with the aim of informing patients of their potential for substantial risk of bodily harm and/or death at the hands of underperforming surgeons.

Researchers have compiled this data into a website called Surgeon Scorecard, which allows patients to search a list doctors and hospitals for past success and complication rates in eight elective procedures. Ranging from hip and knee replacement to lumbar spinal fusion and gallbladder removal, these eight procedures are meant to reflect the greatest actionable statistics for patient decision-making. Since the patients involved in these procedures were typically in good health before the surgery (hence, "elective"), they serve as a control group that most directly reflects the quality of each respective attending surgeon.

Unsurprisingly, Surgeon Scorecard has received a fair amount of criticism, mostly from surgeons and medical spokespeople who are skeptical of patients' abilities to adequately interpret the data. Dr. Joshua Jacobs of the American Academy of Orthopedic Surgeons remarked to NBC News, "I think you need to have a little more information than just this data to choose a surgeon." ProPublica has responded to this ambivalence with a comprehensive account of their methodologies and intentions, ranging from how they selected the procedures to how they weight various doctors according to their location, experience, education, and patient profiles.

It remains to be seen whether Surgeon Scorecard will be effective in its aims to empower patients in the increasingly complex and expensive medical arena. Nevertheless, the issue of unnecessary and often deadly surgical complications remains high on the list of problems to tackle for healthcare administration and public policy generally. Between 2009 and 2013, surgical complications led to more than 3,000 deaths during elective surgery alone (where poor patient health and stability play very little role in the outcome of the procedure). Not only that, but problematic surgeries also contributed to 63,000 readmits of Medicare patients over the same time period. The data is open to interpretation, but the fact remains that improving surgeon performance could make a real difference in patient health. Websites like Surgeon Scorecard don't pass overt judgment on doctors, but they do stand for transparency, and opening the data up to public scrutiny may be the motivation hospitals need to address this long-standing issue.

Sources:
Surgeon ScoreCard
ProPublica – Surgery Risks
NBC News
RAND

About the Author:
Iris Stone is a freelance writer, editor, and business owner who has written on a range of topics. She has experience covering content on medicine, healthcare, and career training, as well as education. Iris is also interested in science and mathematics and is currently studying to be a physicist. Check out her Google+ Profile.

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