How Good or Bad is your surgeon?
As a patient, you should obviously be aware of your particular surgeons results.
Unfortunately, this is not as easy to define as you might imagine. The surgeons themselves,
are not always the best person to the able to judge. Personal bias, subconsciously
or otherwise makes as poor judges of our own outcomes. Fortunately this is well recognised
and no reasonable surgeon would publicise his results without some degree of independent
verification.
Also it depends very much on what you are measuring. Different surgeons have different
case mixes, complexity of surgery and different environments in which they work.
It is therefore important to look not just at the surgeon but the support group he/she
has when deciding where you want to be treated.
Asking a surgeon “How many of these particular procedures have you done in the last
year?” is a simple way of determining if your surgeon is likely to have the experience
needed for your operation. For most procedures, a surgeon should be doing upwards
of 20 cases a year
Is there any way to checkout your standard of care?
There are now publicly available measures that at least attempt to assess crude measures
of outcome.
Even that is not the whole story, as an individual surgeons results will vary from
year to year depending on the group of patients who have presented to him.
Most UK trained and approved surgeons actually practice within fairly narrow limits,
as a result of supervised training and specific monitoring of progress ability and
achievement, such that by the time a surgeon in training reaches consultancy, he
has already reached a safe and satisfactory level of practice. The purpose of monitoring
surgical results after being appointed as a consultant, is a further check on quality.
Because surgical outcomes do vary slightly from year to year, and from patient to
patient, the tools that measure surgical practice are relatively simplistic in the
information they give (e.g. mortality rate revision rate etc) but they at least offer
a consistent guide and identify the so-called “outliers” whose practice needs closer
looking at.
From the patient’s perspective, these outcome measures in the public domain allow
the patient to be reasonably certain that his chosen surgeon has a safe and reasonable
practice.
If you want to check this for yourself, follow the link below to see information
publicly available about my own personal practice
My Results on the National Joint Registry
