[fricat1ve]

In the US, if the surgery is in hospital:

- Well-regarded hospitals will vet surgeons before granting privileges.

- Average hospitals give out privileges fairly easily if there are no actions against a person's license.

- There is a "collegial" review of big screw-ups that carry major reputational risk.

- As with any fee-for-service firm, "rainmakers" are highly sought after and get away with more.

- Privileges are difficult to take away once granted. (Have stronger legal protections than academic tenure in some states.)

If the surgery is in an ambulatory surgery center or doctor's office:

Basically anything goes. Ice-pick lobotomies, tonsillectomy mills, boob job factories in strip malls....all have happened in recent US history. About as well-regulated as traveling carnivals.

[billfruit]

I was thinking something more akin to routine inspection program carried out by independent personnnel applicable to all procedures, not just the reviews that are necessitated due to screw ups.

[fricat1ve]

As far as a performance evaluation that directly scores a surgeon's judgment and whether the procedures s/he is performing are actually beneficial...in the absence of a big screw-up or complaint, I don't believe there is any forum to do that after training is complete.