Report cards a minefield
MEDICAL lobby groups are under attack over their continued fierce opposition to the introduction of report cards on doctors’ performance, as more experts back calls to make such comparative data publicly available.
Peak groups such as the Australian Medical Association and Royal Australasian College of Surgeons reject point-blank proposals to publicly score doctors, saying such moves would penalise doctors — sometimes the best doctors — who see the most difficult cases, and deter specialists from reporting mistakes or even performing risky surgery.
‘‘ It would be a disincentive for surgeons to try new methods or new ways of doing things,’’ said a spokeswoman for the RACS. ‘‘ Surgery is risky, because the people who need it are sick . . . if the Australian public wants report cards, they must be prepared for surgeons to be reluctant to operate on difficult cases, or people who are very ill.’’
But that stance is becoming more difficult to maintain following the adoption of report cards overseas. This week The Australian reported that Justin Oakley, the director of Monash University’s Centre for Human Bioethics, was calling on state and federal governments to help fund a new public reporting system, saying such as scheme would help prevent a recurrence Bundaberg’s ‘‘ Dr Death’’ scandal.
In a new book to be published in August, Informed Consent and Clinician Accountability , Associate Professor Oakley argues that surgeons ‘‘ vary considerably in their ability to conduct particular operations’’.In the introduction to the book, Oakley and coeditor Steve Clarke from the Centre for Applied Philosophy and Public Ethics at Charles Sturt University say such reporting helps patients make better-informed decisions, it fulfils surgeons’ professional obligations to be accountable, and makes it ‘‘ more difficult for substandard individual surgical performance to be concealed’’. The RACS says its own audit of surgical mortality, started four years ago in Western Australia and now national, is a preferable method of picking up problems. However, that system is both anonymous and voluntary, and while the college says 97 per cent of surgeons participate, it is unclear what is done to measure the performance of the 3 per cent of surgeons who stay outside the scheme — or why they have chosen not to co-operate.
‘‘ Some Australian surgeons believe report cards are inevitable here, because it’s happening overseas and because of moves in other professions towards transparency and accountability,’’ Oakley says.
Report cards for cardiac surgeons were Continued inside, page 19