| I would like to give my 2 cents to the discussion, as a Medical Doc who was training to become an Orthopedic Surgeon. One of the problems with Surgical Branches is that beyond a certain point (i.e: Beyond from knowing how to do a procedure) the act of performing a surgery essentially is an art form (Skill). I learned the same from one of the leading Orthopedic Surgeons in India. And that is one of the crucial most factors that differentiates Good surgeon from a Bad One. Although skill can NOT be quantified but certainly in the case of Surgery we can quantify the results of the skills in terms of complications of surgery, recovery and patient satisfaction. One solution to the problem would be : (A) To have a feedback mechanism for doctors. Where they receive a score on their performance and can compare if to other surgeons performing similar procedures. The surgeon would upload a video of all the types of procedures they do every 3 months. And just like NEJM a committee of people provide inputs and rating on the skills of the surgeon. This score in combination with the complication rate and patient feedback would go into making the overall score of the doctor. The doctor will be able to see where he stand in compare to their colleagues from across the country (possible the world). And also for newer (or BAD) surgeons this system would provide a way to learn from the best in the field and improve their skills. (B) If you try to make such a score Public initially, it will receive a huge backslash from the doctors and the industry. But having an internal score keeping mechanism is much better than having no score / rating system. (C) Some hospitals actually do have internal metrics where they track surgeon's performance. In terms of complication rate and other metrics -- but this data is RARELY available to the public. (D) Unless some kind of law is passed at a Federal level in the US, I am not very optimistic about the situation improving. |