Third Party Transparency for Surgeons

The non-profit independent investigative journalism organization ProPublica has announced plans to release a "Surgeon Scorecard" next week.  From the statement:

Millions of patients a year undergo common elective operations – things like knee and hip replacements or gall bladder removals. But there’s almost no information available about the quality of surgeons who do them. ProPublica analyzed 2.3 million Medicare operations and identified 67,000 patients who suffered serious complications as a result: infections, uncontrollable bleeding, even death. Next week, we report the complication rates of 17,000 surgeons – so patients can make an informed choice.

This will be interesting to see.  Many questions immediately spring to mind, however. 

•  Will this just be a massive data dump without any attempt at analysis by knowledgeable medical practitioners?
•  Will there be an attempt to correct for patient factors like age, pre-existing medical conditions, degree of overall health at the time of surgery?
• Will the data break down the cases into elective vs emergency operations?  
• Will they account for surgeons who provide a majority of care to lower income and Medicare/Medicaid patient populations vs those who only rarely operate on patients with subsidized healthcare?  
  
• How will they define terms like "post operative sepsis" and "complication rate"?  Who decides on whether or not to categorize an outcome as "good" or "bad".

I remain wary of the coming publication, of course.  I'm willing to suspend judgement until I get a chance to review it but I think all surgeons are a little anxious about having a third party, non-medical organization present some sort of definitive, simplified "Surgeon Scorecard"  (with A's and B's and F's???) to describe a complex data set for the general public.

I think we as surgeons dropped the ball on this by not being more pro-active in responding to public demands for greater transparency in all professional fields.  We could have gotten involved early, to ensure that what is presented to the public as an evaluation tool is accurate, fair to surgeons, and reliably instructive in guiding patient decision making.  With ProPublica going solo on this, we have lost the ability to mold the narrative.

We shall see how this plays out next week.....