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Beginning in the early 1990s a quality-improvement program began in New York State and has since spread to many other states where report cards were issued to improve cardiac surgery by tracking surgical outcomes, sharing the results with hospitals and the public, and when necessary, placing surgeons or surgical programs on probation. But Sandeep Jauhar writes in the NYT that the report cards have backfired. "They often penalized surgeons, like the senior surgeon at my hospital, who were aggressive about treating very sick patients and thus incurred higher mortality rates," says Jauhar. "When the statistics were publicized, some talented surgeons with higher-than-expected mortality statistics lost their operating privileges, while others, whose risk aversion had earned them lower-than-predicted rates, used the report cards to promote their services in advertisements."
Surveys of cardiac surgeons in The New England Journal of Medicine have confirmed that reports like the Consumer Guide to Coronary Artery Bypass Graft Surgery have limited credibility among cardiovascular specialists, little influence on referral recommendations and may introduce a barrier to care for severely ill patients. According to Jauhar, there is little evidence that the public — as opposed to state agencies and hospitals — pays much attention to surgical report cards anyway. A recent survey found that only 6 percent of patients used such information in making medical decisions. "Surgical report cards are a classic example of how a well-meaning program in medicine can have unintended consequences," concludes Jauhar. "It would appear that doctors, not patients, are the ones focused on doctors' grades — and their focus is distorted and blurry at best."
(Score: 2) by aristarchus on Friday July 24 2015, @03:12AM
you begin to see in stark relief why the needs and wishes of the patient really do need to be taken into account.
Well, no, you ignoramous! Do you have any idea of what is medically possible? No, you do not. That is why you seek the expertise of a professional. Do you disagree with your professional? You are welcome to refuse professional advice, take your family member home to die in the manner you see fit. But do not pretend that the professional is somehow exercising force majure over you, unless, of course, you pose a threat to public health. Point is, for any profession, whether it be law, medicine, academia, engineering, or even the clergy, you do not hire them to do what you want done, you hire them to tell you what you should do, based on their expertise. If you want to go the the faith-healer, homeopath, or Congress, that is your choice. But any functional profession has reasons based on knowledge and experience, and these will (or should!) be a consensus across the profession. This is why rabid religious people cannot be doctors. Or pharmacists. Or, evidently, cake bakers. But they can, as any client or patient, walk away and take their chances with ignorance. Again, simply: the public is not competent to judge professions.
I am getting the idea that I may have been too harsh here, and apologize if you have actually had a bad experience. Such things do happen. But they would be much, much worse if medical decisions where made by bean-counters and angie's list.
(Score: 1, Interesting) by Anonymous Coward on Friday July 24 2015, @04:33PM
Next time, dork, actually read what I wrote and respond to that. It will help facilitate a genuine discussion and exchange of ideas, rather than just talking past me.
Now, on to a real discussion:
On this much we agree.
Actually, sometimes doctors do, in fact, (try to) make unilateral decisions about their patient's care. It happens a lot more than you probably realize. Apparently, explaining the therapies that they prescribe is too time consuming to bother.
Again, on this much, we agree. What needs to be added is that these professionals are not exempt from explaining those reasons to the people under their care. In addition, the patient needs to have the final say in what treatment they receive.
Irony, thy name is aristarchus! You sound just as rabid as any religious fanatic. You might want to reflect on the thought that there are many, many Christian doctors and pharmacists out there. I personally know at least a few. It wouldn't surprise me in the least that you have entrusted your care (and the care of your family) to at least a couple of those "rabid religious people".
And the simple point you have overlooked is that doctors are not omniscient. There are a whole lot of reasons why someone might want to refuse medical treatment. Some of those reasons may be good reasons. Some, less so. But the patient needs to be given the final say in their own treatment. Anything less is to deny the patient's humanity. Clear now?