The following letter was published in The Guardian last week. NSW Health Minister Reba Meagher and others who continue to drag their feet about disclosure of information about the health system here may need a stiff dose of the smelling salts if this crosses their desk.
"The news that surgical mortality rates in England are to be published is a positive development (Report, May 29). But it is not the first time that any government anywhere in the world has released such information. Scotland has already laid claim to that world-first title. Comprehensive surgical mortality data was published in Scotland in 2006 when, following a freedom of information application, I required the health service to disclose the mortality rates of every individual surgeon - not just by hospital unit as is being proposed in England. It is worth recalling that at the time clinicians expressed their concern that the data would be misinterpreted by the public and that surgeons might not carry out high-risk operations for fear of being stigmatised in league tables. Neither of these fears has come to pass. It is a welcome step forward in accountability and transparency to have this type of information proactively published."
Kevin Dunion
Scottish information commissioner
As a surgeon myself I would go for the surgeon and hospital with the highest mortality rate ;) People dying during or in connection with surgery is rare and usually happens in connection with high risk surgery where the patient is sure to die if surgery is not undertaken. Most of these types of surgery are reserved for the tecnically best surgeons and hospitals. Apart from that mortality rate is of absolutely no use as a measure of a the qualifications or skills of a particular surgeon. I am sure more useful measures may be found but in general who is better than who will vary from procedure to procedure. In general: avoid professors as they usually dont do as much surgery as those less academically inclined. Stick with the subspecialised experts at major centres for rare conditions - which surgeon is usually of less interest than which senter as surgeons in teams share knowledege and tricks and will be assisting each other whenever there is a problem that one knows better than the other. When it comes to the common injuries for instance - go with the resident surgeon. He or she is the one doing it on a daily basis while the seasoned surgeon has often moved on to the more special cases and might not have performed the procedure for years. Complicated? Try and have some faith - unless pressure is applied from the outside or there is some kind of out of th, surgical work is administered in a way that takes care of the patient and also the need for educating new surgeons which in turn will benefit the patient and his or her decendants in the years to come.
ReplyDeleteLars - the Norwegian surgeon who came across this entirely by accident
Thanks Lars- a handy perspective.
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