Monday, October 26, 2015

Hsieh Forbes Column On Doctor 'Report Cards' And Unintended Consequences

My latest Forbes piece is now out, "Doctor 'Report Cards' May Be Hazardous To Your Health".

I discuss the rise of physician "report cards" for heart surgeons and other advanced surgical specialties, as well as some of the unintended consequences these report cards can create for patients.

One take home point from my piece:
The report cards can tell you how many patients died under a particular surgeon’s care. But they can’t tell you how many of those patients would have died without surgery. And more importantly, the report cards can’t tell you how many of those same patients would have died if treated by a different surgeon — because each surgeon gets to choose which patients he or she will operate on.

The goal of recognizing good doctors is laudable. But the proposed “report cards” have serious limitations. Patients looking for a good surgeon should consider these report cards as merely one data point among many — and not necessarily the most reliable.
I also cover other ways patients can find a good surgeon, in addition to these "report cards".

Various private rating systems will be a mixed bag, each with their own strengths and flaws. I personally think all such ratings will have flaws that patients need to know about, which is one point of my article. Fortunately, patients can listen to (or ignore) those ratings as long as they remain private.

In contrast, government rating system will be very easily captured by those with agendas that don't necessarily align with patient interests (such as cost containment), and that's where we can potentially see big trouble.

For more details, read the full text of "Doctor 'Report Cards' May Be Hazardous To Your Health".

I also recommend a related article by Dr. Saurabh "Harry" Jha, "When a bad surgeon is the one you want: ProPublica introduces a paradox".