There’s lots of crappy programmers with good reputations too. But it’s a weird reply to “he’s a top tier surgeon” that you say it’s unknowable.
I’m sure you’re right, I’m not a surgeon so I have no idea how to evaluate a good surgeon, but there must be some way to qualify the poor ones from the great ones.
Your anecdote is a great example of high reputation, low skill. But is that the only instance. Is it 10%? Are most board certified, practice for 20 years surgeons good or bad? What’s the actionable intelligence, but it seems like the conversation ends with “it’s unknowable.”
I am sort of aware of quality measurement, but not a healthcare practitioner, but I’ve noticed this comment from lots of docs that the only way to know if medicine is good or bad is to have a doctor review it.
The only people who can differentiate between 1)surgeons who are expert in the O.R. whose patients do well in the long run and 2)those whose reputations exceed their abilities and results are anesthesiologists. Trust me, I was one for 38 years, at UCLA, the University of Virginia, and in private hospitals. I will never forget the time a world-renowned cardiac surgeon at UCLA at the height of his career — holder of an endowed distinguished chair, first author of the then most widely acclaimed textbook in the field, whose surgical skills were so sub-par he was only allowed to operate with a senior cardiac surgeon as his "first assistant" — was repairing a child's AV septal defect by sewing on a patch (on full cardiopulmonary bypass) only to be interrupted by his "first assistant" who quietly told him, "You've got the patch on backwards." I was standing literally two feet from the two of them, behind the drape.