![]()
Talk about accountability in conventional medicine, this week's British Medical Journal discusses what some health professionals feel to be a controversial move in the U.K.: Making the performance of individual surgeons available to the public. Researchers discussed the issues in relation to cardiothoracic surgery.
The inquiry into cardiac deaths at Bristol Royal Infirmary recommended that patients must be able to obtain information on the performance of hospitals and individual surgeons. Since then, cardiothoracic surgeons have been voluntarily submitting figures for publication.
But the arguments for and against publication are finely balanced. Cardiac surgeons in the United States, where public reporting already exists, believe that the system is unfair, as the performance of a surgeon is highly dependent on his or her institution. It may also encourage surgeons to protect their results by avoiding high-risk patients.
The value of such publications also depends on whether the outcome usefully reflects quality of care, the ability to cater for differences in casemix, and whether the publication is designed to facilitate patient choice or show consistency of standards.
EurekAlert August 20, 2004