A new tool allows patients to check out the quality of their surgeon before agreeing to any procedure, but some surgeons are crying foul.
The nonprofit journalism organization ProPublica unveiled a tool Tuesday called Surgeon Scorecards that let patients evaluate a surgeon’s performance. The scorecard takes into account deaths while in a hospital and readmissions to the hospital within 30 days.
The group said Tuesday it assembled five years of data gleaned from Medicare records to create the methodology for the scorecards. Journalists with the project also interviewed scores of experts and had the methodology reviewed by outside experts such as professors of medicine.
A patient can search by location, hospital name or the surgeon’s name.
The nonprofit focused on 16,827 surgeons who perform at least one of eight elective procedures performed usually without complication such as hip replacement, prostate removal and lumbar spinal fusion. By focusing on these routine procedures, normally performed on healthy people, ProPublica believes it will get an accurate representation of a surgeon’s performance.
ProPublica said it undertook the project to improve patient safety and reduce errors.
The Centers for Medicare and Medicaid Services has long had the data.
The agency and most of the nation’s hospitals “have taken the view that it’s better not to calculate or act on this sort of information, in part because it is so controversial,” ProPublica said on its website. “Though no one says it aloud, the attitude has been that the risk of unfairly tarring any doctor trumps all other considerations.”
But the nonprofit argues that patient harm and medical errors have persisted despite efforts to address them.
A 1999 report from the Institute of Medicine called “To Err is Human” brought the issue to the public forefront. The institute found that about 98,000 people died per year due to medical errors.
One of the recommendations from that report was to create a nationwide mandatory reporting system for patient deaths and serious harm, ProPublica said.
“That has never happened.”
But one surgical group complains that the scorecards may not be the answer.
Surgical complications can be complex, and there can be other factors that affect surgery, care and outcomes, according to the American Academy of Orthopaedic Surgeons.
The group said it welcomes transparency and improving patient safety, but emphasized that joint replacement and spine surgeries are “common, successful procedures.”
Another problem is the metric of hospital readmissions. One doctor asked if the data says why someone gets readmitted.
“People get readmitted because they fall or because they didn’t take their anticoagulation medications correctly or because a surgeon missed a fracture on the x-ray,” wrote Dr. Jen Gunter, an OB/GYN and pain physician, on her blog.
Another expert said the readmission measure isn’t valid. “The model uses an indirect measure of complications that fails to properly account for variation in the reasons for a readmission,” Dr. Peter Pronovost, senior vice president for patient safety at the Armstrong Institute for Patient Safety and Quality at Johns Hopkins, wrote on ProPublica’s website.
Others were more accepting of the tool, but had some reservations. The American Medical Association raved that the tool will help physicians improve the quality of care they deliver.
But publishing the data does have some limitations and can lead to misinterpretations that might “harm reputations,” said Dr. Steven Stack, president of the biggest physician group in the country.
Patient safety groups have lauded the tool as an “exciting milestone. This report dramatically illustrates the benefits to the public when Medicare makes its health care information public,” according to Lisa McGiffert with the Consumers Union Safe Patient Project, on ProPublica’s website.
