The searchable database, “Surgeon Scorecard,” was created by ProPublica, a nonprofit journalism organization, by using five years of Medicare records to calculate the death and complication rates for nearly 17,000 surgeons performing one of eight elective procedures including knee replacements, the data include knee replacements, hip replacements, cervical spinal fusion, two types of lumbar spinal fusions, gall bladder removal, prostate resection and prostate removal. The website says the scorecard was “guided by experts” and the data were adjusted for differences in patient health, age and hospital quality.
Click here to find data on Kentucky surgeons.
This analysis comes at a time when federal health officials are focusing more attention on these common surgeries, Laura Ungar reports for The Courier-Journal.
“This month, the U.S. Centers for Medicare and Medicaid Services announced a proposal to cut Medicare payments to hospitals with high rates of complications for hip or knee replacements,” Ungar reports. “About a quarter of the 400,000 hip and knee replacements Medicare patients undergo each year will be affected by the proposed rule.”
ProPublica’s report comes with mixed reviews. Health and Human Services Secretary Sylvia M. Burwell told Ungar that this model would “reward providers and doctors for helping patients get and stay healthy.”
Leah Binder, president and CEO of the Washington-based Leapfrog Group, a nonprofit organization that rates hospitals, told Ungar that she commended ProPublica for analyzing the data in a way that’s useful for consumers. “Complication rates are a strong sign of a certain skill level,” she said. “This information is housed by our government, and as taxpayers, we deserve to know how surgeons are doing.”
Charles Mick, a spine surgeon in Massachusetts who advised on the project, told Nick Penzenstadler of USA Today that the project is “long overdue. Consider baseball, if you’re a batter but never knew if you hit the pitch, how could know you know if you’re getting better?” Mick argued that the “uncomfortable public exposure is a small price to pay for better patient care.”
But surgeons have taken to the Internet with complaints about the report with editorial headlines like: “ProPublica’s Surgeon Score Card: Clickbait? Or Serious Data?” written by Dr. Benjamin Davies for Forbes; “Why the Surgeon Scorecard is a journalistic low point for ProPublica” by Dr. Jeffry Parks on his medical blog; and an open letter titled “ProPublica’s Surgeon Scorecard: Call for Peer Review” by Dr. Edward J. Schloss, to name a few.
These physicians argue that there are problems with the methodology, such as overly wide statistical confidence intervals for complication rates, questions about using readmission rates as a measure of complications, considering readmission as equal to death, and not using enough criteria to make these claims.
“ProPublica rightly has high expectations for surgeons and has courageously started a worthwhile process,” Davies writes for Forbes. “What they have not done is given pause — or honest reflection — on the obvious harsh limitations of the data they have processed. Instead, we got a clickbait video and a parboiled dataset.”