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Tuesday, January 6, 2015

Selecting the right surgeon is a big deal

Workers' Compensation was designed to provide the best available medical treatment possible. A good surgical results benefits all stakeholders. The patient has a better outcome, the employer gains an employee who is productive in the workplace, and the insurance company ultimately pays less indemnification by way of permanent disability and a reduced cost for medical follow up care.

Over the decades since its original enactment 1911, the issue of cost of medical care has come to the forefront. Some states, such as New Jersey, prohibit an employee's free selection of a medical provider. Additionally, some employers and their insurance companies have contractually negotiated a best price fee with medical providers and have an established medical care networks, consequently restricting the employee's free selection.

A recent article authored by Peter Scardino is the chief of surgery at Memorial Sloan Kettering Cancer Center (MSK) focuses on the need to select the best surgeon in order to obtain the best outcome.

“You can think of surgery as not really that different than golf.” Peter Scardino is the chief of surgery at Memorial Sloan Kettering Cancer Center (MSK). He has performed more than 4,000 open radical prostatectomies. “Very good athletes and intelligent people can be wildly different in their ability to drive or chip or putt. I think the same thing’s true in the operating room.”

The difference is that golfers keep score. Andrew Vickers, a biostatistician at MSK, would hear cancer surgeons at the hospital having heated debates about, say, how often they took out a patient’s whole kidney versus just a part of it. “Wait a minute,” he remembers thinking. “Don’t you know this?”

“How come they didn’t know this already?”

In the summer of 2009, he and Scardino teamed up to begin work on a software project, called Amplio (from the Latin for “to improve”), to give surgeons detailed feedback about their performance. The program—still in its early stages but already starting to be shared with other hospitals — started with a simple premise: the only way a surgeon is going to get better is if he knows where he stands.

Vickers likes to put it this way. His brother-in-law is a bond salesman, and you can ask him, How’d you do last week?, and he’ll tell you not just his own numbers, but the numbers for his whole group.

Why should it be any different when lives are in the balance?