Heart surgeons refuse difficult operations to avoid poor mortality ratings

Re:Heart surgeons refuse difficult operations to avoid poor ... by billfruit on Saturday April 21, 2018 @02:17PM (#16892524)

On a related vein, do surgical procedures involve any type of quality control, where the work is independently audited? If so I wasn't aware. Quality control is such an important cogwheel of processes in many other industries, yet I don't hear much talk of it in relation to medical profession.

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Re:Heart surgeons refuse difficult operations to avoid poor ... by fricat1ve on Saturday April 21, 2018 @03:27PM (#16892921)

In the US, if the surgery is in hospital:

- Well-regarded hospitals will vet surgeons before granting privileges.

- Average hospitals give out privileges fairly easily if there are no actions against a person's license.

- There is a "collegial" review of big screw-ups that carry major reputational risk.

- As with any fee-for-service firm, "rainmakers" are highly sought after and get away with more.

- Privileges are difficult to take away once granted. (Have stronger legal protections than academic tenure in some states.)

If the surgery is in an ambulatory surgery center or doctor's office:

Basically anything goes. Ice-pick lobotomies, tonsillectomy mills, boob job factories in strip malls....all have happened in recent US history. About as well-regulated as traveling carnivals.

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Re:Heart surgeons refuse difficult operations to avoid poor ... by billfruit on Saturday April 21, 2018 @03:41PM (#16893008)

I was thinking something more akin to routine inspection program carried out by independent personnnel applicable to all procedures, not just the reviews that are necessitated due to screw ups.

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Re:Heart surgeons refuse difficult operations to avoid poor ... by fricat1ve on Saturday April 21, 2018 @04:19PM (#16893227)

As far as a performance evaluation that directly scores a surgeon's judgment and whether the procedures s/he is performing are actually beneficial...in the absence of a big screw-up or complaint, I don't believe there is any forum to do that after training is complete.

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Re:Heart surgeons refuse difficult operations to avoid poor ... by prepend on Saturday April 21, 2018 @02:33PM (#16892621)

There are process checklist reviews (http://qualitysafety.bmj.com/content/23/4/299) and medical review panels (https://mrp.ky.gov/Pages/index.aspx).

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Re:Heart surgeons refuse difficult operations to avoid poor ... by vermontdevil on Saturday April 21, 2018 @03:29PM (#16892935)

Yes they have process and analysis for quality purposes

You can see one example here

https://www.facs.org/advocacy/quality/phases

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Re:Heart surgeons refuse difficult operations to avoid poor ... by Dayshine on Saturday April 21, 2018 @02:30PM (#16892607)

Yes, at least in the UK, we have a series of national clinical audit programmes.

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