The Publication Of Surgeon Specific Death Rates Raises Controversy

The publication of death rates of patients, specific for every surgeon in Scotland has led to mixed reactions from members of the medical community. A majority of the surgeons feel that the act is misleading and meaningless. The name of the surgeon, list of hospitals in which the surgeon has operated, the total number of patients who underwent surgery and the associated mortality rate are amongst the details published. The request of two journalists for publication of the above information is said to have sparked the issue.

Following approval by Kevin Dunion, Scotland's information commissioner, the official figures have been released, based on the Freedom of Information Act. Similar reports for cardiac bypass surgery have already been published in England and Wales. However the latest Scottish statistical reports is believed to be more comprehensive and authoritative.

In response to the above publication, Dr Harry Burns, Scotland's chief medical officer, has said that it could lead to misinterpretation amongst the public. There is a possibility of doctors losing their profession if they are not competent enough to achieve adequate survival rates. It could also lead to the identification of the best and worst surgeon in a particular country, a trend regarded to be unhealthy.

There are several factors that determine the outcome of a particular surgery. The clinical condition of the patient, the severity of the disease, the presence of other diseases such as asthma, cardiac disease, diabetes, hypertension and the experience of the surgeon are some factors that play a crucial role in this regard. Sometimes, even in the best of hands, many patients fail to recover.

‘Many of those surgeons with the highest mortality rates are the heroes of the health service. They make the difference between life and death. But inevitably, the hardest cases, the sickest patients, have the least chance of survival, ‘said Dr Burns.

To conclude, the ultimate success of any surgeon should be based on patient satisfaction rather than on the basis of patient mortality rate. It would not be fair enough to blame just the surgeon for failure of a particular surgery when a team comprising of doctors, nurses, paramedical personnel is involved in the delivery of quality health care.