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Why Do ASCs Fail? - August 2015 - Outpatient Surgery Magazine

Outpatient Surgery Magazine, providing current information on Surgical Services, Surgical Facility Administration, Outpatient Surgery News and Trends, OR Excellence and more.

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8 O U T P A T I E N T S U R G E R Y M A G A Z I N E O N L I N E | A U G U S T 2 0 1 5 Surgeon Report Cards Get Failing Grade They don't always measure what matters most to patients. T he best joint replacement surgeon looks the worst on the Surgeon Scorecard. He has the most complications — infections and readmis- sions — because he does all the redos and hard cases. But he's hardly a dunce with a slew of demer- its. He's the doc you'd want to give you your new knees. That's the trouble with surgeon scorecards and report cards: They don't always measure what matters most, and they punish sur- geons who perform the riskiest surgeries on the sickest patients. ProPublica released its Surgeon Scorecard project (projects.propubli- ca.org/surgeons) last month. In its first 2 weeks, the online database has been viewed more than 1.3 million times by people looking up doctors — and by doctors looking up doctors, seeing where they stand rela- tive to their peers. ProPublica compared the performance of surgeons by examining 5 years of Medicare records for 8 common elective procedures, includ- ing knee and hip replacements, spinal fusions and prostate removals so that "patients will be able to weigh surgeons' past performance as they make what can be a life-and-death decision." Overall, Surgeon Scorecard looked at 2.3 million surgical procedures and rated nearly 17,000 surgeons by their death and complication rates. Report cards can penalize more skilled and more aggressive sur- geons for operating on patients at higher risk. That's like penalizing a high school student for getting a B in an Advanced Placement course instead of settling for the easy A. Besides discouraging surgeons to shy away from more difficult and complicated high-risk patients, lest they incur higher mortality rates, critics claim ProPublica's analysis of surgical complications, while E D I T O R ' S P A G E Dan O'Connor

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