Scotland: Death rates for each surgeon are published

The Telegraph (U.K.) ^ | February 7, 2006 | Auslan Cramb

[Stoat]

Death rates for each surgeon are published

By Auslan Cramb, Scottish Correspondent
(Filed: 07/02/2006)

The patient death rates for every surgeon in Scotland were published yesterday amid warnings that a league table of surgeons would be "meaningless and misleading".

The figures were released following requests under the Freedom of Information Act. In England and Wales, death rate figures for heart bypass surgery have been published by cardiac surgeons but the Scottish statistics are understood to be the most comprehensive published in any country.

They detail the name of every surgeon, the hospitals in which he or she has operated, the number of patients treated and the mortality rate.

They were made available by the NHS following a ruling by Scotland's information commissioner, Kevin Dunion, after a request from journalists from two newspapers.

But Dr Harry Burns, Scotland's chief medical officer, said the bare statistics were "meaningless" and open to serious misinterpretation.

There are fears in the medical profession that they will be used to identify the country's "worst surgeon", and could prompt doctors to turn down cases in which a patient's survival is not assured.

Dr Burns said: "As a former surgeon myself, I am concerned about how the data might be misinterpreted."

He added that the severity of the illness, and other conditions unrelated to the surgery, could all influence the outcome of an operation. "Many of those surgeons with the highest mortality rates are the heroes of the health service," said Dr Burns. "They make the difference between life and death. But inevitably, the hardest cases, the sickest patients, have the least chance of survival."

Mr Dunion defended the decision, saying surgeons should have no fears about being subjected to a witch-hunt.

[redhead]

LOL! You're right. Nobody wants to come up here when they are feeling puny from living under a brown cloud elsewhere. (We don't mind...it keeps the rifraff out ;o) )

[dinoparty]

Yeah, roughly 29 out of every 30 deaths in March occur during the first 29 days of the month. Mind boggling.

[Taliesan]

Understood. By I, being a free and somewhat intelligent individual, am capable of analyzing such statistics for myself.

No, you're not.

[SmoothTalker]

"Statistics like these can be VERY misleading...
"

I agree with you. A skilled surgeon who takes on more difficult cases will be punished and a less talented surgeon who only does routine procedues will be rewarded.

[redhead]

"Alaska has clean air, but you have to chip it out and thaw it before it does you any good."

LOL! ANOTHER skilfully-placed rumor planted to prevent an influx of Outsiders...!

[Neoliberalnot]

This is a useless piece of information meant to trash an honorable profession. Every case is different in terms of how advanced the condition is, age of patient, and many other surgical risk factors. Referral surgical candidates are often the ones nobody wants to tackle because of the high risk of failure.

How bout publishing lawyers salaries, their win-loss records, etc. When was the last time a lawyer was sued for malpractice? Go figure.

[caveat emptor]

A interesting topic. For anyone thinking the stats should be either not collected or not made available, try expanding that idea to most other goods and services.

A book was published in 1989 describing a situation in California where a group of cardiologists started keeping records on the thoracic surgeons who were operating on their patients because of suspicious anamolies which they wanted to document. The fact that those records were being kept was discovered by a newspaper reporter, who somehow got hold of some or all of the info and ... it's been 16 years since I read the book, and don't remember details of how the lawsuits played out, other than that the cardiologists were on to something, there was a massive coverup by hospitals and a med school, and a senior cardiologist lost his job. And IIRC big payouts to some thoracic surgeons. go figure.

Gripping stuff. My power went out about half an hour ago, I have limited battery backup, and power could be off for hours or days??(I live in very isolated area) otherwise I would do some internet searches to see whats available online. I did a quick amazon search, and didn't find the book.

Title is "Heart Failure"
Author is Thomas J. Moore
ISBN is 0-394-56958-X

I'll be back. I own a copy, and if there's time I'll have a look and do a quick read to see if it's worth following up on.

Nice to have my memory jogged on that one.

[WayneS]

Why not?

[Stoat]

For anyone thinking the stats should be either not collected or not made available, try expanding that idea to most other goods and services

The practice of medicine is unlike other goods and services on a multitude of fronts, and so it really is difficult to compare it meaningfully in this way.

The scenario that you bring forth is a prime example of a reason why this sort of information should not be publicly disseminated....in this case, it would feed those with a passion for fevered and hysterical conspiracy theories about a massive 'surgeon's cabal' intent upon killing patients instead of helping them.  At the moment, the only group I'm seeing who gives credence to this sort of thing are the Islamofascists who make TV series and movies about Jewish doctors abducting Palestinian children in order to murder them for their organs, which they sell to the highest (Jewish) bidder for transplants.

In the EXTREMELY rare times in the past when there has been criminal activity of the sort that you relate, the most meaningful information that ultimately cracked the case has always come from Nurses and other doctors, not from some "reporter' who wants to win a prize or sell a book. 

Raw statistics such as these are meaningless when taken out of context, and they will be eagerly distorted and misrepresented by those who either have an agenda of some sort or simply are oblivious to the realities of how modern medicine is practiced in modern hospitals, or both.

 

[caveat emptor]

The practice of medicine is unlike other goods and services on a multitude of fronts, and so it really is difficult to compare it meaningfully in this way. etc. etc.

It's been a long day, getting prepared for a possible extended power outage (power's back). I'm tired and I find your remarks so offensive that I can't civilly respond to them. Question doctors and you're like Islamowackos accusing Joos of murdering Pali babies for their organs? Sheesh. Are you a can't-we-all-just-get-along-pollyanna, or do you work for Merk-Sharp-Dohme?

[caveat emptor]

merk-sharp-dohme = merck-sharp-dohme

[Stoat]

It's been a long day, getting prepared for a possible extended power outage (power's back). I'm tired and I find your remarks so offensive that I can't civilly respond to them. Question doctors and you're like Islamowackos accusing Joos of murdering Pali babies for their organs? Sheesh. Are you a can't-we-all-just-get-along-pollyanna, or do you work for Merk-Sharp-Dohme?
 

Hopefully you might take a moment to re-read my comments when you are feeling a tad more coherent, as you may discover that what you are saying is not even close to what I had written or meant.

Have a good night and I wish you the best.

[Smokin' Joe]

It is, but there should be some sort of scale for difficulty of cases and probability of nonsurgically related complications, too.

The best surgeons can take on the toughest patients, and considering what they are up against do very well, but not have that reflected in these numbers.

The 'cherry pickers' who only do the easiest cases will have the best survival rates.

Without a difficulty scale, or an explanation of the types of cases, the numbers could be incredibly misleading.

[caveat emptor]

At the moment, the only group I'm seeing who gives credence to this sort of thing are the Islamofascists who make TV series and movies about Jewish doctors abducting Palestinian children in order to murder them for their organs, which they sell to the highest (Jewish) bidder for transplants.

Did you say that, or am I just not quite being "a tad more coherent". Skip the slander and maybe we'll have something to talk about.

[Stoat]

Did you say that, or am I just not quite being "a tad more coherent". Skip the slander and maybe we'll have something to talk about.
 

It was you who stated that you were tired and for most people this means that they are less coherent than usual.  If this is not what you meant, then I am perplexed as to why you even mentioned it, and if telling me that you are tired had no bearing upon your level of coherence, then some additional details as to why you mentioned this would certainly have been helpful..  No offense of unkindness was intended, and certainly no slander.  I was merely responding to something that you had very clearly said.  We seem to be having multiple misunderstandings today, and I find this very unfortunate.  I assure you that I mean no unkindness; I am merely responding to your words.

The specific sentence that you question is relating to the concept of  medical conspiracy theories.  As I said, the only group that I am aware of that puts much stock in such theories are the Islamofascists.  I find nothing outrageous at all about this (the fact that Islamofascists are invested in conspiracy theories), it's rather common knowledge, or so I thought.

This is entirely different from your inference that I had suggested never questioning doctors.....I had never suggest or inferred such a thing.  In fact, the best patients are the most well-informed patients.  Being a well-informed patient means taking the time to learn a bit about the entirety of what it is you are talking about, not merely taking a raw statistic and attaching a meaning to it which oftentimes is not relevant.

[caveat emptor]

Yada yada yada. Why don't you try to be a bit more coherent. This is serious stuff, pal. Not just Bill Clinton trying to con the high school principal.

My mother-in-law, age 88, is in a seniors facility housing ~120 persons, most not that old. Six or so of them are men. The "masculine deficit" are dead. Get it, dead, as in not alive. That's what, 5%! Oh, and skip the personal attacks.