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by epmaybe 3091 days ago
Seems like a bad example. All board certified cardiothoracic surgeons have to report their mortality rates from procedures (there are problems with that, but one could easily look this up). Not to mention most work for a hospital and therefore have a fixed salary. On top of this, most healthcare consumers in America are directed by their insurance provider as to who they can even go to for these sort of procedures.
3 comments
FireBeyond 3090 days ago
> Not to mention most work for a hospital and therefore have a fixed salary.

Unless you have knowledge to the contrary, I'd dispute this. Most physicians, and specialists in hospitals in at least the Pacific North West are NOT hospital employees.

This is how you can get into ridiculous situations where your hospital is "in network", but your provider is not (because of course, you get a choice on the physician you are assigned at a hospital, especially in ED...).

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DrScump 3090 days ago
Mortality rate is a poor metric.

First, it "penalizes" doctors/hospitals that take on the most severe cases. There is no objective metric for "we saved X people who would have died at an average facility." Do you want a metric that would encourage a doctor/hospital to deny an aggressive procedure for fear of taking a hit in its mortality metrics?

Secondly, it ignores ongoing quality of life. A cardiac surgery can have a later death that does not count in its mortality rate, even if it was due to a complication caused by, or significantly contributed to, by inferior medicine.

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epmaybe 3090 days ago
Oh, I'm in agreement, and should have made my point about this more clear. The reason I brought it up at all is that there are other external factors that influence a patients decision, or lack thereof, in choosing a CT surgeon for their non urgent (or emergency I guess, but there's even less choice there) procedure.
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monkeyprojects 3091 days ago
I'm in the UK not the US. The example is actually a friend who has watched his private practice (1 day a week) expand as he tried to reduce demand by increasing his rates.
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epmaybe 3091 days ago
Oh, I see. I figured you were talking about the US due to the article. Your friend works one day a week?? That's awesome.
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monkeyprojects 3091 days ago
4 days NHS (the day job), 1 day private practice. That's typical for Consultants in the UK...
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epmaybe 3091 days ago
After I posted the comment I figured that was the case.
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