Two new, unrelated search tools opened to the public Tuesday promise to make elective surgery planning easier and more transparent. They’re delivering on that promise by arming patients with information about thousands of surgeons’ previous patient outcomes.
The sites — SurgeonRatings.org and Surgeon Scorecard — organize Medicare fee-for-service data into searchable databases. The data was extremely difficult to obtain, said Robert Krughoff, founder and president of Center for the Study of Services/Consumers’ Checkbook, the organization behind SurgeonRatings.org.
“We sued the federal government for access to this data back in 2006,” said Krughoff, “But it wasn’t until October of last year that the federal government finally released this data in full.”
SurgeonRatings.org rates more than 50,000 surgeons in the United States using Medicare data from 2009 to 2012. To use the tool, patients enter a ZIP Code and then select a desired surgical procedure from a list of 14 operations, which includes gastric surgery, hip or knee replacement surgery, prostate removal surgery and spinal cord exploration.
The team behind SurgeonRatings.org worked with doctors and statistician consultants to carefully judge surgeons based on several complex criteria including death rates, adjustment for pre-existing patient conditions and evaluations by other doctors.
Two reasons a doctor wouldn’t be in this database? If the physician didn’t have enough Medicare records to be fairly evaluated or if their results were worse than average.
“This time around, we decided we would focus on the good. In the future, I’m sure we will choose to reveal those doctors with worse than average outcomes,” Krughoff told CNN.
The other website, Surgeon Scorecard, evaluated nearly 17,000 surgeons across eight of the most common elective procedures in Medicare data from 2009 to 2013. On Surgeon Scorecard, patients can search by specific location, state, hospital or surgeon name.
“We thought we would find ‘good’ and ‘bad’ hospitals. … But what we actually found was a quite a bit of variation between surgeons within the same hospital,” said Marshall Allen, a reporter for ProPublica, the organization behind Surgeon Scorecard.
“The surgeon is the captain of the ship,” said Allen. “And there’s an incredible amount of variation between surgeons regarding complication rates.”
Surgeon Scorecard used a multistep process to calculate surgical complications for each doctor.
To begin, they excluded trauma and high-risk patients, and adjusted for age, patient health, luck and overall hospital performance. Then with the help of 24 physicians, the Surgeon Scorecard team reviewed patients who were readmitted to the hospital within 30 days after their surgery and judged whether the readmission was related to the operation. If a patient’s case made it though all of these filters, then it was considered a complication.
But are Medicare patients representative of how skilled a surgeon is overall? Krughoff said yes.
“How well doctors do with Medicare patients is very similar to how the doctor does overall,” said Krughoff.
While these tools could be useful for comparing complication rates, they aren’t the only metric a patient should use when picking a surgeon or a hospital, said Krughoff. “I’d also want to know how well the physician communicates with patients.”
“Why wouldn’t you want to shop around?” asked Allen. “The data doesn’t tell you who is to blame for the complications, but it is understood that the surgeon is responsible for the patient in all steps of the care.”