Leapfrog surgery standards miss the mark

In regard to “Most hospitals fail to meet Leapfrog’s surgery volume standards,” (ModernHealthcare.com, July 18), I hope that Leapfrog will look at the unintended consequences of those standards.

I am responsible for completing the Leapfrog survey for a hospital system with nine acute-care hospitals, ranging from bed sizes of just over 100 to almost 700. We are struggling with the best way to reach the standard, but are not even reporting this measure because of these issues illustrated:

What if a small hospital in a rural area has an excellent thoracic surgeon who has taken care of the community’s lung cancer patients for years and probably saved many lives, but only has about six lung cancer patients a year? Are we to tell that surgeon s/he can no longer do those surgeries because it doesn’t meet Leapfrog’s arbitrary standards? Where should those lung cancer patients go?

Under the Leapfrog standard, if two surgeon partners work together on difficult cases, such as abdominal aortic aneurysms, only one can be credited with the case volume.

Under the Leapfrog standard, there are hospital minimum volumes and physician minimum volumes. If a surgeon works at two or more hospitals, s/he will get credit for the surgeon volumes at all the hospitals, but the hospital volume may still be low because the surgeon’s cases are spread out among the hospitals.

Is Leapfrog proposing that their standards lead to a nationwide system where all patients needing high-risk surgeries be funneled to major medical centers that may be miles—even states—away from their homes and families?

Our state already has medically underserved patients due to low population density regions with a lack of acute-care hospitals. Many small hospitals in those rural areas are closing or have already closed due to regulatory and financial burdens. Are we going to force these small hospitals and their surgeons to stop providing necessary, life-saving procedures within their communities for the sake of getting four “cell phone bars” on the Leapfrog Hospital Survey? I hope not.

These are my personal opinions and do not represent those of my employer.

Melissa Cornwell Marietta, Ga.