Having enjoyed tremendous success with my previous installment called "NewsShots", I bring to you another new installment: "Medical Monitor".
"Medical Monitor" will focus on ethical dilemmas in facing the NHS today and Dubitatio's take on how these dilemmas could be brought to rest.
As always, read the article, formulate your own opinions, and answer the survey on the side. I look forward to hearing your own take on whether surgeon performance should be monitored.
"Good surgeons should be encouraged to take on tough cases, not just safe, routine ones. Publishing an individual surgeon’s mortality rates may have the opposite effect."
This statement suggests that as a result of publishing surgical mortality rates, surgeons are likely to avoid challenging cases which may be detrimental to their mortality figures. The net effect of such behaviour is an overall decline in the quality of surgeons.
The publication of such data is a vital patient safeguard to prevent the recurrence of rogue doctors such as Dr Harold Shipman who (although not a surgeon) killed large numbers of patients. Transparent mortality rates also empower patients to understand the risks of the respective procedure better as well as allowing patients to compare one surgeon with another. This information along with the NHS’ ‘Choose, and Book’ process increases patient control of their health and healthcare.It is likely that by comparing one surgeon to another, this will likely incentivise them to improve the quality of their work to reduce mortality rates which would be to the benefit of patients.
It would be hoped that league tables would change a surgeon’s behaviour for the better through improved care; however, it is likely that it would also have adverse effects as well. Many surgeons would be more reluctant to operate on a ruptured aortic aneurysm due to the significant associated mortality. As a result of this change in behaviour, whilst the surgeon’s mortality rates will go down, the overall mortality for patients with this presentation would likely increase due to the limited option for surgical intervention. Thus, the underlying goal of publishing such information (to reduce patient mortality) is defeated.In theory, phrases such as acting ‘for the good of my patients’ as stated in the Hippocratic Oath and GMC guidelines on Good Medical Practice would suggest that surgeons’ behaviours should not change in this way as a result of surgical mortality rates publication. However the reality is likely to be very different.
What do you think? Let me know on the side, and in the comments below.
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