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EVALUATING SURGEON ERROR RATES TO ASSESS RISK OF MEDICAL MALPRACTICE

This summer, ProPublica published a scorecard comparing how 17,000 surgeons throughout the United States performed on common procedures. US News called the scorecard “the first purely objective public report card of health care quality at the physician level.” While the report was controversial, potentially unfair to some surgeons, and highly contested by some experts, it can still be an important tool for patients who need to undergo a surgical procedure and who are concerned about the risk of medical mistakes.

Medical errors are very common, and ProPublica warned in its report that choosing a good hospital is not enough to make sure you have a good surgeon. Doctors at some of the best facilities nationwide had high rates of surgical mistakes, which could lead to harm to patients and to medical malpractice claims. Patients who are going to be undergoing surgery should consider checking out their surgeon on ProPublica’s report card before they make a decision on where to undergo their medical procedures.

Some Surgeons Have Higher Error Rates Than Others

ProPublica examined five years of Medicare records for eight common elective surgical procedures, including prostate removal, knee replacements, hip replacements, and spinal fusions. Post-surgery complication rates were determined for different surgeons who performed the eight common procedures.

Overall complication rates were assessed by reviewing patient billing records, with ProPublica accounting for patient health and age when evaluating post-procedure complication rates. This reliance on Medicare claim data was criticized by some who do not believe the surgeon report cards were accurate. However, Centers for Medicaid and Medicare Services (CMS) collects significant amounts of data on patients, providing a large body of information on surgical procedures and post-surgical complications for researchers.

ProPublica’s report card found a small share of doctors account for a significant number of surgical complications. In fact, 1/4 of all complications experienced by patients undergoing common operations were caused by just 11 percent of doctors performing the surgeries.

Some of the surgeons with the highest rates of complications worked in academic medical centers considered to be among the best facilities in the nation. For example, one surgeon at nationally-recognized Johns Hopkins Hospital was found by ProPublica to have 10 times more complications than all colleagues combined even though other doctors performed nine times as many of the same surgical procedures.

Some with the lowest rates of complications, on the other hand, were surgeons at clinics in a small town in Alabama who personally handled every aspect of patient procedures and follow-up care.

Patients need to be aware some doctors have complication rates which are much higher than others. Before undergoing surgery, patients should check the ProPublica report card. It is possible to search by location and by surgeon name in order to determine whether a provider has a higher-than-average rate of post-surgical problems or whether the surgeon they are considering tends to have patients who recover without incident.

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