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I am not repeating this to be pedantic - this is simply a common misunderstanding in the public: > Never mind that Josef Mengele was a licensed physicians, or

I am not repeating this to be pedantic - this is simply a common misunderstanding in the public: > Never mind that Josef Mengele was a licensed physicians, or that the AMA was well established before the Tuskegee syphilis experiments The AMA has no role in licensing physicians, a task which is left to the states. > Heart surgeons refuse difficult surgeries to juke[sic] the stats. This is far more complicated than it seems. For example, consider that the sickest/most difficult patients are the most likely to die, irrespective of an intervention. At a certain point, the harm inherent to surgery outweighs any potential for benefit that the surgery might yield.

tialaramex 8y ago
The Heart surgeon thing is likely referring specifically to a UK press article recently featured on HN that was about surgeons in the UK reacting to a policy change that means their stats are shown to the general public. A large minority of those surveyed said that as a result they now refuse to do surgeries they think will be very bad for their stats, even if clinically the surgery might be appropriate and within their competence. A majority said they knew a surgeon who had made such choices. As a patient in that system (the NHS) I would prefer my surgeons not to make decisions based on trying to game the statistics. If I need heart surgery, I want whoever is competent and available. So if these stats block that, I'd rather we don't have the stats. Frankly it's weird anyway because surgery is a team activity, not solo. Nothing serious is done by one bloke in a surgical gown, there's a team. I had a relatively minor operation and the named surgeon will have spent most of that operation _talking_ not operating. All the sewing and some of the cutting will be the nice younger doctors I met, a woman who'd been doing this a few years and was well on her way to being an actual surgeon, and a new bloke who seemed like he'd probably graduated just a couple of years ago. The old bloke with the paperwork saying he's allowed to cut people open is mostly there to watch over them both and step in if things go to shit. The woman is doing most of the work, showing the noob what she's doing and maybe overseeing while he stitches me back up at the end. There's some Eastern European doctor lady making sure I neither die nor wake up, and two or three nurses making sure everybody has what they need, and counting things to make sure nothing is left inside me that shouldn't be there. But if I'd died (very unlikely for minor surgery) it would count against my named surgeon and not the rest of the team.

tialaramex 8y ago

The Heart surgeon thing is likely referring specifically to a UK press article recently featured on HN that was about surgeons in the UK reacting to a policy change that means their stats are shown to the general public. A large minority of those surveyed said that as a result they now refuse to do surgeries they think will be very bad for their stats, even if clinically the surgery might be appropriate and within their competence. A majority said they knew a surgeon who had made such choices. As a patient in that system (the NHS) I would prefer my surgeons not to make decisions based on trying to game the statistics. If I need heart surgery, I want whoever is competent and available. So if these stats block that, I'd rather we don't have the stats. Frankly it's weird anyway because surgery is a team activity, not solo. Nothing serious is done by one bloke in a surgical gown, there's a team. I had a relatively minor operation and the named surgeon will have spent most of that operation _talking_ not operating. All the sewing and some of the cutting will be the nice younger doctors I met, a woman who'd been doing this a few years and was well on her way to being an actual surgeon, and a new bloke who seemed like he'd probably graduated just a couple of years ago. The old bloke with the paperwork saying he's allowed to cut people open is mostly there to watch over them both and step in if things go to shit. The woman is doing most of the work, showing the noob what she's doing and maybe overseeing while he stitches me back up at the end. There's some Eastern European doctor lady making sure I neither die nor wake up, and two or three nurses making sure everybody has what they need, and counting things to make sure nothing is left inside me that shouldn't be there. But if I'd died (very unlikely for minor surgery) it would count against my named surgeon and not the rest of the team.