Most surgeons do not do enough cases over their entire careers to be meaningfully compared to their peers. There was a big paper about this recently. The ratings are a sham meant to instill false confidence.

Can you link the paper?

I can't remember what journal it was published in and google isn't helping.

I found this for hospital-level comparisons (these should be much more accurate due to far larger numbers): https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4250275/#!po=2....

However: "Most commonly reported outcome measures have low reliability for differentiating hospital performance."

Agreed! There are shit doctors and great doctors, but they all have one thing in common... the Dr. preceding their name! They have resisted for good reason. I mean, when you have a bad day at the office, some code or deal or possibly something else breaks. When a surgeon has a bad day, it is not so simple and it is easy to forget they are human.

I have worked countless full arrest codes in the field... countless. Some go a lot better than others, and some are even successful. Most codes are do not end well for the patient whose heart has stopped beating or the drive to breathe has stopped. I can't imagine having stats of the codes we work pushed in our face everyday. There are sooooo many variables that we don't control which would make the whole "measuring" endeavor meaningless to anyone that really cared. From the weight of the patient to the cleanliness of the house are all variables that may or may not matter. Good luck controlling for all that!

"There are shit doctors and great doctors, but they all have one thing in common... the Dr. preceding their name!"

I usually look at a doctor's reputation, experience level, education, publication, etc. as signals for "quality." It CAN vary drastically, as in, one doctor might overlook a diagnosis or even mis-diagnose something that another, more experienced doctor would catch correctly.

Every one of these proposed quality signals is prone to error. Publication history I would see as a negative quality signal. Less experience means more likely to be up-to-date on latest treatment techniques and algorithms. Reputation in the "Best Doctor" survey sense usually correlates with years in practice more than actual quality. The best indicator, in my experience, is to ask a nurse at that hospital who they would send a family member to for that specific problem. Even board certification does not hold great discriminatory power, in my experience. Analysis of these indicators would make for a worthwhile research project, but the more beneficial project would be to try to identify and disseminate those behaviors that form mechanisms of quality.

The latest Freakonomics podcast addressed this issue as well: http://freakonomics.com/podcast/bad-medicine-part-3-death-di...

Have you looked at https://www.ratemds.com ? I was forwarded this recently and I found it very interesting

I have used a similar service, and found the results to be helpful in finding a general practicioner.

Tracking revision and mortality rates for surgeons would be much more helpful. I have been told (by engineers who have worked on joint replacements) that some surgeons have revision rates well over 50% (and frequently leave patients with one leg longer than the other), while others have revision rates well under 10%.