Re­port cards a mine­field

The Weekend Australian - Travel - - Health - Adam Cress­well Health ed­i­tor

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

Newspapers in English

Newspapers from Australia

© PressReader. All rights reserved.