Posted on 12/06/2006 10:43:34 AM PST by A. Pole
Massachusetts health officials have decided to publicize the patient death rates for individual heart surgeons, the first time the state will release information on the quality of care provided by individual doctors --not just by hospitals and physicians' groups .
Beginning Dec. 18, it will be possible to go to a website and look up the mortality rates for 55 surgeons who perform cardiac bypass operations. About 4,000 patients had bypass surgery at 14 Massachusetts hospitals in 2004, according to the state's most recent figures. It is one of the most common operations.
[...]
In New York, where mortality data for individual cardiac surgeons have been released since 1991, state officials credit the program with lowering death rates, but surgeons in Massachusetts are worried that public reporting could hurt care by discouraging doctors from taking high-risk patients who are more likely to die.
[...]
Dr. George Tolis Jr., the new chief of cardiothoracic surgery at Caritas St. Elizabeth's who was a surgeon in New York, said the program has not improved care. He said some surgeons have low mortality rates because they refuse to operate on high-risk patients.
Tolis said the problem is that states' analyses cannot fully account for all of a patient's risk factors, so that surgeons who take higher-risk patients still end up looking like they get worse results.
[...]
(Excerpt) Read more at boston.com ...
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.
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.
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?
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.
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.
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.
Are you saying that avoiding financial risk is not a market mechanism?
It should be listed for every doctor, every state. Natural deaths and un-natural.
Cessation of brain activity?
more lawyers, less surgeons...that's what I always say
/sarc
The Law of Unintended consequences is at work here..
Idiots.
How do you propose eliminating this financial risk for doctors?
"Natural deaths and un-natural"? What do you mean?
Sure, let's add a subjective element to an already slanted/misguided/uninformative statistic! THAT would help things! =^)
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?
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!"
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