Surgeons’ ratings

SIR – Samer Nashef raises an important point about the unintended consequence of publishing individual cardiac surgeons’ mortalities (report, June 3). Inevitably some surgeons, particularly younger or less experienced ones, are hesitant to operate on a high-risk patient, knowing that a bad outcome will affect their published mortality ratings.

When the Society for Cardiothoracic Surgery started the annual UK Cardiac Surgical Register in 1977, we published annual mortality statistics for cardiac operations from the 43 cardiothoracic units then in Britain. This had a major impact in improving results for common cardiac surgical operations as individual surgeons could compare their results with what was being achieved both nationally and within their own unit.

There would be value in returning to the publication of unit (hospital) mortality statistics for individual operations, leaving it to surgeons to decide who among them is best-fitted to operate on higher-risk patients. Sir Terence English Oxford