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Heart surgeons refuse difficult operations to avoid poor mortality ratings
31–40 of 274 posts
Re: Heart surgeons refuse difficult operations to avoid poor mortality ratings
#32Check out the comments over on /r/medicine and you will likely be horrified. It is career over everything. There was even a thread this week about how you should NEVER correct someone above you (med students should never correct a resident and a resident should never correct an attending). That mentality is terrible for everyone and every thing, except the physicians' careers. I don't know if we need to select for be…
Yes, the system is horrendous and broken. There should be complete oversight and full transparency for self-regulation purposes, which includes ongoing learning and education, and get lawyers involved once the self-regulating is found to be inadequate - such as a surgeon who repeatedly makes the same mistakes and hasn't bothered to learn or care to improve their skills, or prevented from continuing.
From my own struggles of trying to find healing for chronic pain I have, I have realized that doctors/professionals are selected for for their memorization and not for critical thinking skills.
Re: Heart surgeons refuse difficult operations to avoid poor mortality ratings
#3366% of 115 specialists polled did not refuse a difficult operation. 33% thought about how it would impact their statistics, or put more generously, thought hard about the probability of the patient surviving presumably quite serious surgery. Yes mortality is a blunt statistic for a surgeon, but perhaps giving people pause for thought about the odds of success is no bad thing. Contra point: would you rather not know h…
Do not Doctors Surgeons disclose the potential errors and things that might go wrong in the US? I have had several ops in the last 18 months in the UK and they always go though what can go wrong and tell you the odds.
Re: Heart surgeons refuse difficult operations to avoid poor mortality ratings
#34If you’re a patient, wouldn’t this still mean starting with the lowest-mortality surgeon? If they take your case, you’re least likely to die. If not, you have a better appraisal of your odds.
Re: Heart surgeons refuse difficult operations to avoid poor mortality ratings
#35Why don't we keep track of refusals as well?
Re: Heart surgeons refuse difficult operations to avoid poor mortality ratings
#36it's been said a few times on /r/medicine, surgeons have their lawyer in mind when operating, they're skilled, but they first avoid anything that could damage their own life irreversably. Of course to an extent this goal aligns with the patient, but not always, and a bit sad on the ideal side.
Re: Heart surgeons refuse difficult operations to avoid poor mortality ratings
#37It's Goodhart's Law in action, this time with deadly consequences: "When a measure becomes a target, it ceases to be a good measure."[a] [a] https://en.wikipedia.org/wiki/Goodhart%27s_law
Ironically applied to not-good hearts
Re: Heart surgeons refuse difficult operations to avoid poor mortality ratings
#38The subjective is always where there is value. I wish there were surgeons that would accept these challenges and colleagues would objectively assign a degree of difficulty score. And a site that aggregated such scores. I really don’t care how “friendly” a doctor is - did the get the diagnosis right? Did they improve longevity? Did they improve quality of life? Not easy to score but what everyone wants to know.
Does the NHS provide enough free market choice that anybody could take advantage of a score even if they wanted to?
Yes, my father is currently undergoing treatment for cancer (involving multiple surgeries) and had issues with a surgeon. He was given the option to choose a different surgeon or even transfer to another hospital entirely.
Re: Heart surgeons refuse difficult operations to avoid poor mortality ratings
#39It was not heart surgery, but after being diagnosed with lung cancer, my mother had one of her lungs removed by a surgeon who assured us he'd be able to get all the cancer. She had a miserable, painful recovery that I would not wish on anybody. Within a week or two of her recovering to the point where she could walk short distances, the cancer was found in her other lung and went on to kill her within a few more mont…
How doctors die (2011):
Re: Heart surgeons refuse difficult operations to avoid poor mortality ratings
#40Some doctors probably refuse patients that left bad reviews at competing offices...