Tuesday, 25 October 2011

Individual Consultant Outcome Reporting is Poor Health Policy

The decision by the society of cardiothoracic surgeons of Great Britain and Ireland to publicly report individual surgeons' outcomes on a regular basis  was inevitable. No other avenue was open to them after the Bristol Paediatric heart surgery scandal and the efforts of Sarah Boseley who, in 2005, used the Freedom of Information act to obtain the death rates of every heart surgeon in the country. The Society president at the time of the Bristol imbroglio was none other than the current Medical Director of the NHS, Bruce Keogh.
Patient choice is an integral part of the NHS reforms. Patients will be able to choose their own consultant - hence the importance of publishing outcomes of individual consultants. I have always felt that the variation between outcomes after surgery is more likely to be due to deficiencies of process and pathways of institutions rather than differences in abilities of individual clinicians. It is more important and informative for patients to be able to choose the institution where they want to be treated based on published outcomes rather than individual consultant surgeon. This article from an American cardiothoracic surgeon expresses the same sentiment. KevinMD.comCardiac surgery is a team sport