Surgeons refuse to operate to keep their personal statistics clean.
Empirical studies evaluating the impact of public surgeon report cards and outcome tracking have found no evidence that surgeons refuse to operate or become risk-averse to protect their personal statistics.
The claim posits that surgeons refuse to operate to keep their statistics clean (a form of risk aversion prompted by performance tracking). While some opinion and commentary pieces raise concerns about potential risk aversion or defensive medicine, empirical population-level studies explicitly examining this question in specialties like vascular surgery and colorectal surgery found that patient selection and treatment rates did not drop following the public reporting of surgeon outcomes. Therefore, the direct evidence refutes the claim.
A Saratzis, A Thatcher, M F Bath, D A Sidloff, M J Bown, J Shakespeare, R D Sayers, C Imray. Reporting individual surgeon outcomes does not lead to risk aversion in abdominal aortic aneurysm surgery.. 2017. https://doi.org/10.1308/rcsann.2017.0005
This study investigated whether reporting individual surgeon outcomes for aneurysm surgery leads to risk aversion and found no evidence that surgeons became risk-averse in their patient selection.
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Abigail E Vallance, Nicola S Fearnhead, Angela Kuryba, James Hill, Charles Maxwell-Armstrong, Michael Braun, Jan van der Meulen, Kate Walker. Effect of public reporting of surgeons' outcomes on patient selection, "gaming," and mortality in colorectal cancer surgery in England: population based cohort study.. 2018. https://doi.org/10.1136/bmj.k1581
This large population-based cohort study found that the introduction of public outcome reporting for colorectal surgeons did not lead to risk-averse clinical practice or gaming of data.
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