Monday, 13 June 2011


I have posted this paper because it is written by authors who I know and who I hold in high esteem and it highlights an issue that I have written about previously. I also have very personal experiences with this particular example - i.e young adults with aortic valve disease being denied the Ross operation . Every cardiac surgeon knows that public reporting of outcomes has this very serious downside to it. Patients will get offered a treatment that may offer better early outcomes for them and the surgeon whose performance is being reported, even if late outcomes are not as good as they could be with alternative treatments. They are being offered treatments that suit the surgeon and are not in the patients best long term interests - as Des Spence would say in the BMJ - Bad Medicine indeed!