Certainly you may not be worried about this, but when there are human beings involved one has to be more careful. With any physical process, you can change some

Certainly you may not be worried about this, but when there are human beings involved one has to be more careful. With any physical process, you can change something by just applying force. Changing the status quo in situations like these is harder. The harder you push, the more they'll form a rock wall against your demands. Nobody wants to protect the poor surgeon. But everyone knows the tragic fact: each one of them was a poor surgeon at some procedure at some point. Experience made them better. The article stresses the importance of the way these things are done. In order to have surgeons participate you need to earn their trust. Show them that you're not out to 'expose the failures' so to speak. Besides, the idea that surgeons will only take easy cases is not a hypothetical. The article lists instances where gaming occurred. In fact, it stresses the importance of confidentiality in gaining surgeons' trust in ensuring this doesn't happen. Like in everything else, we should treat how to change systems as a science and the evidence looks like it favours Amplio's approach to the problem. Maybe in some years from now things will be different and more information can be public. But for that to succeed we need to get there carefully.