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Heart surgeons refuse difficult operations to avoid poor mortality ratings

telegraph.co.uk

231–240 of 274 posts

Re: Heart surgeons refuse difficult operations to avoid poor mortality ratings

#231
post #58

Earlier quoted context omitted.

> Just compare the rates of disease for vegans with the general population. "Disease" is such a broad category that it's sort of meaningless here. Maybe veganism is healthier than an animal diet, but the degree of its impact can only be stated only after removing the many other environmental factors that might be contributing to lower disease rates among vegans, including income and location.

Yes, lot's of things are always involved. Including air quality etc as I think I saw on HN just the other day. I find it interesting though that the right type of vegan diet will basically make you hypertension and heart attack proof and that it may also reverse heard disease (the only diet to do so). Especially when you look at mortality and costs of healthcare this really need to be more generally recognized.

> I find it interesting though that the right type of vegan diet will basically make you hypertension and heart attack proof

A diet making someone heart-attack-proof is a pretty strong claim. Have a citation?

I think the only thing one can say with near-certainty about a well balanced vegan diet is that it has much lower environmental externalities (i.e carbon footprint, water usage) than a meat-based diet, while being no worse for you than any other comparably healthy diet.

That alone is a great reason to be a vegan, without having to rely on possibly hyperbolic claims of health benefits.

Re: Heart surgeons refuse difficult operations to avoid poor mortality ratings

#232
My mother went two years with a horrible stomach condition and couldn't get anyone to treat it until she wound up in the hospital and they were legally required to treat it. It was for exactly that reason: risky surgery looks bad, even if it's necessary. When there aren't a lot of doctors who can perform the surgery in question to begin with, say only two in your state, then you might just die.

Re: Heart surgeons refuse difficult operations to avoid poor mortality ratings

#233
post #210
post #37

Earlier quoted context omitted.

Ironically applied to not-good hearts

"These doctors are vile dogs. If I was a physician I would take all the hard patients, heal them all, and be a hero of the people." Yeah, if you were given one operation where the patient has a 100% chance of dying without it, but 80% of you killing them if you operate + 20% chance of them living after, maybe you'd do this once and get lucky. But try doing this twice, you have a a 96% chance of killing a patient, thr…

I am pretty sure that the parent was referring to the fact that this article is about heart surgeries. Bad heart is used in the same manner as a bad knee or a bad tooth. It refers to the patient not the doctor.

But aside from that, I completely disagree with your comment. The approach you are defending, even if legal, is completely unethical and immoral. It should be something we chastise, not condone.

Re: Heart surgeons refuse difficult operations to avoid poor mortality ratings

#234

Earlier quoted context omitted.

One problem is that fee-for-service incentives strongly distort what people think they "know full well."

Correct me if I am wrong, but don't doctors in the UK get paid a salary instead of the fee-for-service model prevalent in the US and Canada?

For NHS hospital doctors (including heart surgeons) that's true. General practitioners may be salaried or equity partners (the system is largely by contract to doctors' offices rather than directly employed). There is also a small percentage of non-NHS private work, though this is mainly in routine elective work rather than high-risk heart surgery.

Re: Heart surgeons refuse difficult operations to avoid poor mortality ratings

#235
post #210

Earlier quoted context omitted.

"These doctors are vile dogs. If I was a physician I would take all the hard patients, heal them all, and be a hero of the people." Yeah, if you were given one operation where the patient has a 100% chance of dying without it, but 80% of you killing them if you operate + 20% chance of them living after, maybe you'd do this once and get lucky. But try doing this twice, you have a a 96% chance of killing a patient, thr…

I am pretty sure that the parent was referring to the fact that this article is about heart surgeries. Bad heart is used in the same manner as a bad knee or a bad tooth. It refers to the patient not the doctor. But aside from that, I completely disagree with your comment. The approach you are defending, even if legal, is completely unethical and immoral. It should be something we chastise, not condone.

Well I think you're an idiot. There's only one viable "approach", determined by the laws of probability I described above. You can try to shame people into doing actions that would ultimately get them fired and sued, but you're only going to look like a self-righteous asshole and nothing will happen.

Re: Heart surgeons refuse difficult operations to avoid poor mortality ratings

#236

Earlier 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.

This is systems thinking in action. It reduces failure demand[0].

[0] https://en.wikipedia.org/wiki/Failure_demand

Re: Heart surgeons refuse difficult operations to avoid poor mortality ratings

#237
post #235

Earlier quoted context omitted.

I am pretty sure that the parent was referring to the fact that this article is about heart surgeries. Bad heart is used in the same manner as a bad knee or a bad tooth. It refers to the patient not the doctor. But aside from that, I completely disagree with your comment. The approach you are defending, even if legal, is completely unethical and immoral. It should be something we chastise, not condone.

Well I think you're an idiot. There's only one viable "approach", determined by the laws of probability I described above. You can try to shame people into doing actions that would ultimately get them fired and sued, but you're only going to look like a self-righteous asshole and nothing will happen.

Hey, this is a little too ad hom...

Re: Heart surgeons refuse difficult operations to avoid poor mortality ratings

#238
1/3 of heart surgeons violate medical ethics. That shows how flimsy and easily corrupted doctors are. That they don't really care about doing what's best for their patients' health as soon as an incentive makes that inconvenient. I hope some more data will reveal who has statistical anomalies in who they're turning away so the frauds can be identified.

Re: Heart surgeons refuse difficult operations to avoid poor mortality ratings

#239
post #210
post #37

Earlier quoted context omitted.

Ironically applied to not-good hearts

"These doctors are vile dogs. If I was a physician I would take all the hard patients, heal them all, and be a hero of the people." Yeah, if you were given one operation where the patient has a 100% chance of dying without it, but 80% of you killing them if you operate + 20% chance of them living after, maybe you'd do this once and get lucky. But try doing this twice, you have a a 96% chance of killing a patient, thr…

Yet another reason (among many) the US is such a backwards country.

Re: Heart surgeons refuse difficult operations to avoid poor mortality ratings

#240
post #72
post #59

Earlier quoted context omitted.

Can someone really sue their surgeon in the US?

Absolutely. You can sue for pretty much anything. Winning is another story, but doctor's don't generally make sympathetic defendants. Juries know they have money and that they pay huge insurance fees to cover these cases. Of course, after losing a big case where the insurance company pays out millions of dollars, they likely become uninsurable and unemployable. But hey, the money is good until you hit the anti-lotter…

If he really had a pattern of gross incompetence, wouldn't there have been some other process to stop him doing that? Are courts really that incompetent themselves that they can't understand such simple statistical errors as using survival rate to measure competence?
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