Death rates per doctor to be listed

The Boston Globe ^ | December 6, 2006 | Liz Kowalczyk

[NittanyLion]

Folks, before you comdemn this remember two things:

1. The only way to fix healthcare is to inject more free market mechanisms into the sector (google "consumer driven healthcare" for more info)

2. Transparency of information is a prerequisite for any free market

I see this as a very positive first step. There's no reason we shouldn't have a "Consumer Reports" for medical care providers.

[Kozak]

But if you want to give people market choice they need to have access to the verified data, don't they?

Then add another stat on the average operative risk of the cases the doctor is preforming. Juat tossing out the raw number is misleading.

[A. Pole]

Then add another stat on the average operative risk of the cases the doctor is preforming. Just tossing out the raw number is misleading.

Still, a doctor can estimate varied risks WITHIN defined/averaged category and cherry-pick the lower risks patients.

Who will measure the risk? If doctor, he can inflate the risk (increase credit for success and lower the blame for failing). If someone else, doctor will reject cases with the risk evaluated lower but pick evaluated higher.

Medicine is an art, second guessing doctors is often impractical.

[A. Pole]

The only way to fix healthcare is to inject more free market mechanisms into the sector

And how the free market can work in emergency? How do you shop for better or cheaper service when you have stroke or heart attack?

How do you use free market in a smaller town when there is not much choice?

[NittanyLion]

And how the free market can work in emergency? How do you shop for better or cheaper service when you have stroke or heart attack?

You rely upon the best doctors being at hospitals because of previous choices made by educated consumers, because hospitals now have a busines interest in hiring only the best physicians, etc. Not all that different from any other free market.

How do you use free market in a smaller town when there is not much choice?

You travel to a larger town. When one has a life threatening disease (relatively inexpensive) travel is not a barrier to choosing a doc.

[therut]

I agree it will make physicians not take on critical patients where surgery is life or death. They will just do surgery on stable patients. I have seen this happen in other specialities because of malpractice. Many neurosurgeons, orthopedic physicians will not do trauma patients. Sad because there are alot of good physicians whom patients need. You will get taken care of by residents in a teaching hospital. Sue lawyers for this.

[Alberta's Child]

This is a good example how the market mechanisms might lead to the less medical care for the sicker people.

Baloney. This is really a good example of how idiotic exposure to undue financial risk by doctors makes them hesitant to treat very sick people.

Unless you intend to force doctors against their will to treat everyone, your point is completely meaningless.

[A. Pole]

This is really a good example of how idiotic exposure to undue financial risk by doctors makes them hesitant to treat very sick people.

Are you saying that avoiding financial risk is not a market mechanism?

[sweetiepiezer]

It should be listed for every doctor, every state. Natural deaths and un-natural.

[Mr. Lucky]

Cessation of brain activity?

[RckyRaCoCo]

more lawyers, less surgeons...that's what I always say
/sarc

[cbkaty]

This puts the pressure on high-risk procedures.... Seems only natural that the best surgeons that perform the big-risk operations will become reluctant or even shut down and called quacks.....

The Law of Unintended consequences is at work here..

[Teacher317]

My brother-in-law is a neonatologist, and specializes in the highest-risk preemies. His rate is likely unflattering. Does this mean he should abandon all those high-risk infants, so he can "pad his numbers"?

Idiots.

[Alberta's Child]

Maybe in one sense it is. But since the financial risk in question involves the one aspect of medical care that is distinctly not "free market" in nature (i.e., exposure to lawsuits that have no basis in fact), then I don't know what your point is.

How do you propose eliminating this financial risk for doctors?

[A. Pole]

Natural deaths and un-natural.

"Natural deaths and un-natural"? What do you mean?

[Teacher317]

Sure, let's add a subjective element to an already slanted/misguided/uninformative statistic! THAT would help things! =^)

[A. Pole]

But since the financial risk in question involves the one aspect of medical care that is distinctly not "free market" in nature (i.e., exposure to lawsuits that have no basis in fact), then I don't know what your point is.

Are you saying that "exposure to lawsuits" is not a part of the free market? But if you eliminate legal responsibility how can you have enforceable contracts?

[Alberta's Child]

Are you saying that "exposure to lawsuits" is not a part of the free market?

Sure it is. But when most of these lawsuits involve junk science, jury decisions that have no basis in fact, etc., then it ain't "free market" at all.

If you want to see the free market at work in this regard, just go back and do some research on Toyota's development of a new light truck plant here in the U.S. After a long site selection process few years ago they narrowed their search down to locations in Texas and in Mississippi. Mississippi went to great lengths to entice Toyota to build the plant there, but their efforts were futile. Toyota's legal department did extensive research on the legal climates in both states, and they determined that -- due to Mississippi's history of exorbitant jury awards and its idiotic civil litigation system -- the financial risk of opening a major manufacturing plant in Mississippi was greater than the risk of buying a grain farm in Zimbabwe. So San Antonio got the $850 million Toyota facility (the assembly line started operation about three weeks ago), and much of Mississippi continues to look like a Third World toilet.

The doctor who refuses to treat high-risk patients is no different than the Toyota executive who tells the government of a dysfunctional place like Mississippi to "F#&% off!"