“When the statistics were publicized, some talented surgeons with higher-than-expected mortality statistics lost their operating privileges, while others, whose risk aversion had earned them lower-than-predicted rates, used the report cards to promote their services in advertisements.”
Gathering and analyzing the statistics is nonetheless a good idea. Refining the comparison cohorts would be an improvement, but the first thing I’d do would be to reduce the visibility. If the only person who saw a particular doctor’s numbers was that doctor, he or she could decide whether variance was due to exogenous factors or a signal to take steps to improve. The direct link to an incentive (operating privileges) is, as usual, a driver of dysfunction.
What would you do?
http://www.nytimes.com/2015/07/22/opinion/giving-doctors-grades.html
(Shout-out to Garth Shoemaker for bringing this article to The Mole’s attention.)