When a bad surgeon is what you want...

[drusso]

We will see similar paradoxes emerge in pain and spine care:

http://www.kevinmd.com/blog/2015/07...you-want-propublica-introduces-a-paradox.html

"This highlights a curious ethical issue. If a patient has a right to know about a surgeon’s performance, the point estimate, should they not be informed about the methodological limitations of that measurement, the confounders, the confidence interval — which is as large as the elephant in the room?

No, some will say, it’s information overload. But limiting the information we give patients just because we think they can’t handle the information has a name. What’s it called again? Ah yes, paternalism."

---

Members don't see this ad.

 

[Jitter Bug]

Well if an article can in 5 minutes explain why a high complication rate may be based on the morbidity of the patients rather than technical skill, I can explain that too, when I hand out that referral. Part of our job is to know our local physicians in other specialties, their strengths and weaknesses, and when to send them patients.

This is part of what chafes me so much about the idea of "keep them in the system". It only works if you have built the world's best system. What if a better surgeon is across town but linked with a totally different health system? Sometimes I have to cross party lines and piss off my administrative overlords to handpick better specialists for my patients. Most of the time I just hope it goes unnoticed.

 

[hyperalgesia]

I believe a doctor is listed with a gold star on Medicare's directory if he fulfills certain inane non-medical criteria. No one believes a damn thing the government publishes so it's just par for the course and a waste of time and money.

 

[Ducttape]

Well if an article can in 5 minutes explain why a high complication rate may be based on the morbidity of the patients rather than technical skill, I can explain that too, when I hand out that referral. Part of our job is to know our local physicians in other specialties, their strengths and weaknesses, and when to send them patients.

This is part of what chafes me so much about the idea of "keep them in the system". It only works if you have built the world's best system. What if a better surgeon is across town but linked with a totally different health system? Sometimes I have to cross party lines and piss off my administrative overlords to handpick better specialists for my patients. Most of the time I just hope it goes unnoticed.

your hospital system cannot prevent you from referring a patient to an outside doctor, if it is in your best clinical judgement to do so.

at least, thats what my hospital administrators tell me. and they have never given me flack for referring to private neurosurgeons or the U.

 

[geauxg8rs]

They can't require you. But they can always find some bogus reason to fire you or just cut your pay in half when its new contract time.
I think it applies more to PCPs since they are more easily replaceable. But if an administrator thinks they can find a better toady they will.