RATE YOUR SURGEONS

Rankings based on patient deaths

RANKING surgeons based on the number of patients to have died on their operating table has been discussed at a large meeting of medical experts.

Surgeon “league tables” have been publicly available in the UK since 2014 as a way of improving standards.

Based on data collected by the National Health Service, surgeon performance is measured against a set of professional standards such as patient survival rates and the number of operations performed.

While controversial, visiting British cardiothoracic anaesthetist Andrew Klein says they are a useful tool for patients and their families and suggested they may work in Australia.

“If it was my mother or my wife or any member of my family, I would want to know which hospital they are going to and details about the surgeon, including their patient mortality rates,” Dr Klein said.

For the patient, if the surgeon has nothing to hide then it should be published because people “do fear death”, he said.

The comments were met with caution by the Royal Australasian College of Surgeons.

Mr John Batten, RACS President, said he was open to greater transparency regarding surgeon performance but stopped short at supporting league tables, that include survival rates, being made available to the public.

He warned careers would be destroyed under such a move.

“If you made that public, what would happen?” Dr Batten said.

“That would be the end of that surgeons career.”

Mr Batten also said simple league tables would drive up hospital waiting times.

Identifying surgeons who are not meeting performance standards was the responsibility of the whole hospital system, said Dr Batten.

A study in 2015 examined the effect of 127 surgeons and 190 anaesthetists on the mortality of 110,000 cardiac patients over 10 years at 10 UK hospitals.

Overall, the study found surgeons accounted for 4 per cent of the risk of death, while the patient’s health accounted for 96 per cent of the risk of death.

Dr Klein, who spoke at the annual scientific meeting of the Australian and New Zealand College of Anaesthetists (ANZCA) in Sydney yesterday, called for researchers replicated such a study in Australia.

“It would be worthwhile because then you could look at the variability between surgeons and anaesthetists in Australian hospitals to see whether there are any noticeable differences and then see if it should be reported in the public domain,” he said.