Easily solvable. Have a person whos jobs it is to rank how likely a person is to live. He gets paid based on how accurate he is.
Doctors would then be ranked as an offset from this previous mortality prediction.
Heart surgeons refuse difficult operations to avoid poor mortality ratings
181–190 of 274 posts
Re: Heart surgeons refuse difficult operations to avoid poor mortality ratings
#182Earlier quoted context omitted.
Low mortality is a good damned measure. I don't want to be operated on some yahoo surgeon who unconditionally operates regardless of risk and has a high mortality track record as a result.
Then maybe mortality rate should be attributed to doctors not operating as well. Low mortality is a good metric on patients, not doctors. But on the other hand, I don't want to be treated by a doctor who cares more about his sellable stats than saving lives.
Maybe it's a good metric for hospitals. There are other pressures discouraging hospitals from rejecting patients altogether, or such is my impression, anyway.
Re: Heart surgeons refuse difficult operations to avoid poor mortality ratings
#183Earlier quoted context omitted.
I meant if you left a bad review somewhere else... Of course someone should not go back where they don't like to go....
That only works if you have more than one choice available.
The shitty US health/dental insurance system make it hard, but I still would be surprised if most people don't have a choice of more then one doctor...
Re: Heart surgeons refuse difficult operations to avoid poor mortality ratings
#184Earlier quoted context omitted.
Perhaps the patient should have the right to decide what that threshold is for themselves rather than having the information hidden from them.
What information? Apparently the doctor told them he could do it. If he really believed in himself, then he told the patient everything she needed to know. Remember, the other option is "go die". So assigning a percentage chance on the successful outcome of a surgery is utterly meaningless when the alternative is a 100% "go die".
respectfully, this isn't the way to conceptualize any medical therapy. it's never "this will save you" or "go die", it's always "you will eventually die, this might forestall it, we're never sure, and there's a big list of potential drawbacks."
a person who can be helped by a medical intervention will die no matter what, but if they get an organ transplant or a pacemaker or continuous dialysis or a cancer removed, they may live a little bit longer, as far as scientists observe, although sometimes with significant difficulties. immunosuppression and chemotherapy both deactivate certain organ systems.
no one can see the future. cancer treatments seem to help some people and be useless for others, and it might all come down to something like, "uh cancer stem cell #13491340 was not destroyed, and there was metastasis." the idea with tumor excision is usually to prevent there from being so many potentially-metastatic stems.
Re: Heart surgeons refuse difficult operations to avoid poor mortality ratings
#185Earlier quoted context omitted.
When I was fresh out of a school I worked in a call center for a while. One of the most important metrics (and everything you did was measured) was the average length of each call. So it was common practice, when you got cases that basically were going to be long calls or ones you probably couldn't actually resolve (e.g., "I want the service back on but cannot pay"), to deliberately upset the customers so that they w…
I'd also expect a bunch of "I'm going to transfer you... oops, pressed a wrong button and it hang up!" As a customer, I've had a fair measure of mysteriously hang up calls to support, I wonder how many of those are metrics-driven...
There was recently a story about a 911 operator being jailed for hanging up on thousands of calls.[1]
If someone could get away with it at a 911 call center, it could happen anywhere... and might happen oftener than we think.
[1] - https://www.sfgate.com/news/article/911-dispatcher-sentenced...
Re: Heart surgeons refuse difficult operations to avoid poor mortality ratings
#186Earlier quoted context omitted.
I'm not an expert in cardiatric medicine or anything, but couldn't patient risk be determined by objective factors like patient age and history of previous heart issues?
This is like asking why software project estimation can't just be done by looking at the size of the project to be built.
I don't see how the analogy works. The entire point is you have a medical record with objective characteristics that can be tied to the risk of any given procedure.
Re: Heart surgeons refuse difficult operations to avoid poor mortality ratings
#187That means there's an opportunity / gap in the market.
Demand for risky operations by motivated buyers, should lead to some doctors taking on the role / label of risk-takers / explorers.
Since they can get the customers other, risk averse doctors are turning away, and pull in rare-treatment seekers on their own.
Re: Heart surgeons refuse difficult operations to avoid poor mortality ratings
#188Earlier quoted context omitted.
When I was fresh out of a school I worked in a call center for a while. One of the most important metrics (and everything you did was measured) was the average length of each call. So it was common practice, when you got cases that basically were going to be long calls or ones you probably couldn't actually resolve (e.g., "I want the service back on but cannot pay"), to deliberately upset the customers so that they w…
I worked in a call center, as well, but they didn’t prioritize call length as a metric/KPI. Their number one KPI was “first call resolution”, meaning even if it took an hour as long as the problem was resolved the call was considered a success. I feel like it was a much healthier way to measure call center performance.
We rotated through all of them and our pay was tied substantially to them, which I guess also created an incentive to make it hard to get good metrics all the time on the part of someone else in the organization.
Re: Heart surgeons refuse difficult operations to avoid poor mortality ratings
#189I firmly believe that this is why my mother-in-law died. She needed surgery to fix a hernia that basically left her unable to eat at all. Is she did not have the surgery she was going to die. The surgeon stopped the surgery because the 'risk' was too high. 48 hours later she was dead.
You don't die in 48h from not eating. So many elements missing there, this is such a terrible depiction. I hope anyone passing by will have a bit of critical thinking.
Re: Heart surgeons refuse difficult operations to avoid poor mortality ratings
#190Earlier quoted context omitted.
Does this mean that I can threaten to not talk to their supervisor?
Ooh good tactic. Mention something like ‘Got all day and I’m not gonna hang up until we get this solved properly.
I mean, in general, a hostile tactic like this is likely to get the agent to do as little as possible as he can to help you while staying within the rules. Plus in many cases the front-line agent doesn't have the permissions to do what you need anyway and has to transfer you to a "supervisor" (usually not actually one) or a retention guy to resolve your issue anyway.