You can now pick a surgeon after their score, which is published in an online database at prorepublica.org. The scoreboard has been criticized and has spurred a lot of controversy on account of the fact that it severely damages the reputation of respectable, hard-working doctors who may have just had bad luck.
Yet, how much bad luck can one single doctor have, how often can you have the misfortune of complications? According to some very recent studies, medical error is still the number three cause of death in the U.S. This statistic alone is alarming enough to justify such a “surgeon scoreboard,” ProRepublica’s Stephen Engelberg claims.
Imagine that you are to undergo a basic procedure, like lumbar spinal fusion. You may think twice before readily choosing the doctor who recommended you the surgery. After all, how much do you know this man? It is his job and he must do it right. Yet you cannot know that will be true. You are forced to assume that it will be ok. Yet, prior to this system’s launch you had no way of knowing how many of the doctors’ patients had survived surgical interventions by him. That is exactly the mentality behind the initiative.
To make this project come to life, the team of scientists made use of data already available from the Medicare program. They had requested the data which was effortlessly given to them. For a test period of five years, so as to provide relevant-over-time data, the team analyzed how many operations the 17 thousand surgeons in the database had performed. For these procedures, the looked at how many of the cases developed complications, either while still in hospital, or when they went home.
The results were combined into complication rates for each specific operation, for each specific doctor. These complication rates were not simple fractions, but, Engelberg says, they also took count of how dangerous the types of surgery were, and of the likelihood of problems appearing. They also added a bad luck factor for cases with complications, as well as a good luck factor for situations which went smoothly.
Therefore, the people from ProRepublica defend their results by saying that, like all statistics, it’s just there to provide an idea, and not to scare people away from doctors. They also have many disclaimers on their website, saying that there may be erroneous cases, or situations in which the patient’s specificity differs much from previous cases.
To see how this works, one example surgeon, which was suggested by the website’s search bar, had lumbar spinal fusion listed as an operation. He had performed the anterior technique 297 times, with just 1 to 10 complications. This led to a low complication rate of 2.8%. For the posterior technique, slightly fewer patients made the complication rate rise by 0.1%.
I would’ve gladly chose the doctor if I were to need the surgery. Would you? Also, how do you think Dr. House would fare in this scoreboard?