Dr. Karen Donelan, a senior survey scientist from the Mongan Institute for Health Policy at Harvard-affiliated Massachusetts General Hospital, and colleagues created reports on several fictitious surgeons. The reports included information on the number of coronary artery bypass graft operations performed, the number and percentage of patients who died during or soon after the operation, and risk-adjusted mortality. The reports were presented in four different formats. How well volunteers were able to identify the "best" surgeon depended on how the information was presented. With the best format, 66% of those surveyed picked the best surgeon; with the worst, just 16% did.
Many people focused on the number of deaths rather than on the more important number—risk-adjusted mortality. It takes into consideration the overall health of the surgeon's patients at the time of surgery. "Most tertiary care hospitals care for very sick people who are referred because they may be too complicated for a community hospital to handle. Sicker patients are at higher risk for poor surgical outcomes," says Dr. Donelan. Looking at mortality rates that do not adjust for these risks may scare people away from outstanding surgeons who often operate on the sickest people.
Because using publicly reported statistics may not be the easiest way to choose a heart surgeon, the Heart Letter asked Dr. Donelan and two other Harvard-affiliated doctors, heart surgeon Lawrence H. Cohn and cardiologist Andrew Eisenhauer, for other options. They suggest:
· Trusting your cardiologist's referral
· Doing some homework
· Meeting with the surgeon to make sure you are comfortable with his or her personality
· Asking the surgeon about your personal risk
Read the full-length article: "Choosing a heart surgeon"
Also in the November 2012 Harvard Heart Letter:
Which is better: angioplasty with stent placement or bypass surgery?
Tracking down the causes of unexplained shortness of breath
Beware of "holiday heart syndrome"
Why you need a flu shot if you have heart disease
The Harvard Heart Letter is available from Harvard Health Publications, the publishing division of Harvard Medical School, for $20 per year. Subscribe at www.health.harvard.edu/heart or by calling 877-649-9457 (toll-free).
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