Which specialty has the most direct "work to outcome" correlation?

[punkedoutriffs]

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Which specialties do you guys think reward physician competency/effort with patient outcome most directly?

A few examples:

Internal med, especially outpatient, has a large "patient compliance" component, where how well the patient does is not always up to the physician.

Regarding neurosurgery, neusu in his thread said that, "There is a phenomenon in neurosurgery, and other surgical specialties I presume, that for certain cases there is an acceptable loss. Essentially, a complication or long-standing negative outcome from the surgery that, though undesirable, is acceptable."

So although these two fields are pretty different, they are similar in that they both contain elements outside of the physician's control that can determine patient outcome. So which specialties do you guys think have the fewest or least drastic "uncontrollable" elements?

 

[PreMedOrDead]

With my limited understanding of specialties, I would say orthopedics.

Patients come in with significant difficulties (not being able to pronate, inability to walk, etc) and can often nearly fully recuperate (pronation, walk, etc). A lot of these are minimal risk and maximal reward.

Edit: Of course, there are subspecialties in orthopedics that work with things like the spinal cord, which could be far more complicated in risk, reward, and outcome. But generally, I would tend to think the above is true, though I expect to be proven wrong via something like derm or path. 😆

 

[Moosepig]

With my limited understanding of specialties, I would say orthopedics.

Patients come in with significant difficulties (not being able to pronate, inability to walk, etc) and can often nearly fully recuperate (pronation, walk, etc). A lot of these are minimal risk and maximal reward.

Edit: Of course, there are subspecialties in orthopedics that work with things like the spinal cord, which could be far more complicated in risk, reward, and outcome. But generally, I would tend to think the above is true, though I expect to be proven wrong via something like derm or path. 😆

Not saying you're totally wrong, but like diabetic IM patients not taking their meds, a lot of ortho patients don't recover well because they don't do on-their-own rehab.

 

[ShenanigansMD]

Outcome is subjective, so I don't think there's a real answer here.

But after reading Emperor of All Maladies it's probably not oncology; again though that's subjective.