Measuring the quality of surgeons is like measuring the quality of policemen or firemen or lawyers or politicians. It just isn't done. And even if it could be

Measuring the quality of surgeons is like measuring the quality of policemen or firemen or lawyers or politicians. It just isn't done. And even if it could be done - how are you going to enforce quality once you measure it? By suspending the bottom 20%? There is already a shortage of surgeons. And surgeons are paid poorly for their work and their investment in education. You cannot pay the better ones more-It is not a free market- prices are fixed by government decree. And physician reimbursement is ONLY tied to work volume (Relative Value Units billed) Frankly, I would be scared to be a patient in the US now; cannon fodder in war of the medical industrial complex versus the third party payers. Insurors would rather pay multimillion dollar salaries to executives and hospital CEOs instead of a quality assurance program. Incentives are aligned to maximize profit, which constantly and carefully measured. Shareholder return is the single most important metric of a publicly held company like Blue Cross, United Health Care, etc. Quality is a pass/fail grade based on outdated measures designed to be politically correct.