For years, if you wanted to order a pizza, you could consult numerous sources, such as Yelp or Google Reviews, to see who was the best.
And only your dinner was at stake.
But if you wanted rating information on doctors performing high-risk surgery, the same subjective scrutiny given to a Domino’s order was all that was available.
That didn’t make sense to Stephen Engelberg. Especially considering preventable hospital errors are now the third leading cause of death in the United States — resulting in 440,000 deaths annually.
So, Engelberg, editor-in-chief of the nonprofit ProPublica, decided a year ago to use big data to peel back the curtain to give patients an accurate picture of who’s holding the scalpel during these procedures.
“These days, consumers can review ratings on everything from plumbers to hair salons to the latest digital cameras,” he wrote in an editorial published Tuesday. “The process of undergoing surgery includes some of the most consequential decisions any of us ever make. So we began with the view that the taxpayers who pay the costs of Medicare should be able to use its data to make the best possible decisions about their healthcare.”
‘Surgeon Scorecard’ Evaluates Performance
ProPublica released Surgeon Scorecard, a search engine that uses data from 63,173 Medicare patients who were readmitted to the hospital after eight elective procedures from 2009 to 2013.
Those surgeries were knee replacement, hip replacement, gallbladder removal, lumbar spinal fusion — both posterior and anterior technique — prostate resection, prostate removal, and cervical spinal fusion.
During that time, 3,405 Medicare patients died during a hospital stay for those elective procedures.
But instead of taking the figures at face value, the ProPublica team evaluated cases of hospital readmission and surgeon mistakes to give potential patients an idea of who has high rates of complications.
In 1999, a report from the Institute of Medicine, titled “To Err is Human: Building a Safer Health System,” called for a national reporting system of serious adverse effects, including death, related to hospital procedures.
However, no such system has been established.
In the light of government inaction to the growing problem, ProPublica used Medicare data to create the database that assesses surgeon-specific — not merely hospital — data related to complications that arise from these common procedures.
“Our reporting suggests that this reluctance to focus on individuals is one reason that patient harm has persisted in the face of considerable effort by the medical establishment,” Engelberg wrote.
A Similar Database for the Best of the Best
While the ProPublica database evaluates surgeons on their best and worst days, another new search engine, SurgeonRatings.org, ignores surgeons with low ratings and focuses on the ones with higher success rates.
The site, powered by the nonprofit Consumers' Checkbook/Center for the Study of Services, analyzed more than 4 million operations conducted by 50,000 surgeons in the United States.
The site doesn’t include the kind of “buyer beware” scenarios of ProPublica, only those doctors with positive ratings on surgeries.
Those procedures include pacemaker surgery, femur fracture repair, gallbladder removal, heart bypass, hernia repair, hysterectomy, major bowel surgery, prostate removal, and spinal cord fusion.
“For more than 20 years, we have evaluated hospital performance using these types of data, and spent many years pushing and suing the federal government to release the data for doctors,” the website states. “Thanks to some forward-thinking people in the government, it's finally now available.”
Now, as more large groups of data are available to the public, consumers can expect to get a better look into the practices and outcomes of those providing care in the U.S. healthcare system, an industry that reached $2.9 trillion in spending in 2013.