European Stars and Stripes (Newspaper) - June 4, 1991, Darmstadt, Hesse                                Id your health let the patient beware will consumer reports on doctors boost chances of survival ? by Malcolm Gladwell _ the Washington Post s seventeen of every. 100 patients who had coronary bypass surgery last year at the hands o Quot dry Quot a Mew York heart surgeon never made it out of the Hospital alive a. That is not a Good record. A by contrast some of that surgeon s colleagues have a mortality rates for the same operation of less than 5 percent this Means that or. X s patients could have Cut their risk of dying on the operating table by More than two thirds if they had been Able to find a better doctor. Unfortunately it is not As easy As that. The new York. Health department which compiled or x s statistics will not reveal his identity. A in the past few years researchers have shown that. Significant differences such As the ones that separate or. X from his colleagues a exist in the Quality of care offered by individual doctors Irr everything from a complicated life saving procedures to delivering babies. And consumer advocacy groups have urged that patients be Given information about the performance records of doctors to guide their Choice of physician. But deciding How much of this information to release to patients a and How to release it has proved difficult and controversial. Or. X s statistics Tor example were said to have been adjusted to account for the possibility that his patients were generally sicker than the patients of his Peers,.but a hair Numis a fam keel a \ a a a a the credentials of doctors dentists and surgeons have always been examined by some of their patients. That adjustment is Only an estimate. And the statistics do a hot indicate whether he is incompetent or simply a inexperienced in which tease Hetman improve with time. Nor do they make Clear whether he is entirely at fault or whether he is plagued by incompetent nurses poor a Anaesthesiologist a or a badly run Hospital. A a a. Is it really fair in other words to represent a a. 1 a complicated procedure such As coronary bypass surgery. With one statistic a. ,. A a i think it s important for patients to have enough information about their doctors to be comfortable Quot said Nancy Dickey a Board member of the american medical association a but at this  re not in  to suggest that there Are magic numbers that can be. A plugged into a formula. It is inappropriate to mislead. Patients into believing that there Are Quick and easy t answers Tosh Cir question Quot i think ultimately we Are headed toward a Fulk disclosure situation Quot said Howard Hiatt a researcher at Harvard University a school of Public health. But unless this kind of information is handled with great care and a lot of understanding to have it leak out can be very very unfortunate. It has to be done in a framework that helps. People understand Howit fits into general practice a the push to collect and release Quality of care \ statistics to come in part from health insurers who Quot want to make sure that the escalating amounts they pay for health care Are being veil spent begin tag in the late Quot 1930s, for example the department of health and a human services began issuing a list of the mortality rate of every Hospital in the country Tor medicare patients undergoing any of nine common procedures or suffer rec any of eight common medical conditions. A a. A the cause also has been taken up by consumer advocates who have argued that As a matter of. Principle patients should  about everything trom How Good their doctor is to whether he or she has Ever been penalized or disciplined. A. -. Quot there is no one a Short of a spouse Lover or family. A with whom a patient will have a More intimate _ relationship Quot with than a. Physician a said Sidney Wolfe who has been in the forefront of the patients right to a know movement for 20 years. He is the director of the health research group a Branch Rof the consumer a advocacy group Public citizen. A a a. ,. I Here is no one Short of a spouse Lover or family a with whom a patient will have a More intimate relationship with than a physician Sidney Wolfe health research group Page 14 a the stars and stripes tuesday