Surgeons quit over rankings

A British move to publish league tables for surgeons, revealing what percentage of patients have died on their operating tables, has led to some having to take up new careers as Uber drivers.

The president of New Zealand and Australia’s surgical college has cautioned against any similar moves on this side of the world, saying it would end too many careers and increase patient anxiety.

In recent years, data made publicly available by Britain’s NHS has revealed mortality rates and the number of operations performed by more than 5000 surgeons in the United Kingdom.

Patients can search by hospital, and by surgeon, and see percentage rates of death, re-admission and other performance measures depending on the surgery, British cardiothoracic anaesthetist Dr Andrew Klein said in a talk to colleagues from around the world yesterday.

If a surgeon falls below a 95 per cent bar, not only does it show on their public profile – their chief executive will be alerted and they can be suspended.

For cardiothoracic surgeons, the data has been available since 2005 and has led to between 20 and 30 of them being deregistered , Klein said.

‘‘They lose their job, their income, their family. There’s a couple driving Uber cabs. I know because I went in one.’’

John Batten, president of the

Royal Australasian College of Surgeons (RACS), said measuring performance was important but he felt any move to make that information public in systems such as the ones in Australia and New Zealand would be a step too far.

‘‘If you made that public, what would happen? That would be the end of that surgeon’s career,’’ he said.

‘‘Do you know how long it takes to train a surgeon?’’

Batten felt the internal mortality audits each year in Australia and New Zealand went far enough to raise flags on people who weren’t performing well.

Kiwi specialist anaesthetist Dr Ben Griffiths said the NHS system would be useful in spotting outliers if replicated in New Zealand.

He was concerned though that there could be ‘‘dangerous misinterpretations’’ if data was seen out of context.

‘‘Doctors work with life and death things and obviously want to do their best. To what extent is it right to scrutinise somebody so much that they can no longer work?’’

Klein’s talk, titled ‘‘Why surgeons kill people and anaesthetists don’t’’, was made to anaesthetist colleagues at the annual Australian and New Zealand College of Anaesthetists (ANZCA) conference in Sydney.

According to a 10-year long study that Klein co-authored in 2015, anaesthetists have little bearing on mortality rates.

His study examined the effect of 127 surgeons and 190 anaesthetists on death rates of 110,000 cardiac patients at 10 UK hospitals.

It found that a patient’s health accounted for 96 per cent of the risk of death in surgery, while surgeons accounted for 4 per cent of the risk.