Are the best coronary artery bypass surgeons identified by physician surveys?

• Published in: American journal of public health (1971) Vol. 87; no. 10; pp. 1645 - 1648
• Main Authors: Hartz, A J, Pulido, J S, Kuhn, E M
• Format: Journal Article
• Language: English
• Published: Washington, DC Am Public Health Assoc 01.10.1997; American Public Health Association
• Subjects: Attitude of Health Personnel; Biological and medical sciences; Clinical Competence; Competence; Coronary Artery Bypass - mortality; Coronary artery bypass surgery; Coronary vessels; Data Collection; Databases, Factual; Datasets; Evaluation Studies as Topic; Health participants; Heart surgery; Hospitals; Humans; Identification; Medical sciences; Medicare; Mortality; Outcome Assessment (Health Care); Patients; Physicians; Polls & surveys; Public health; Public health. Hygiene; Public health. Hygiene-occupational medicine; Ratios; Reputations; Risk Factors; Surgeons; Surgery; Surveys; Thoracic Surgery - standards; United States; USA; Validity; United States; North America; America; Human; Survey; Aortocoronary; Health staff; Bypass; Surgery; Cardiovascular disease; Vocational aptitude; Performance; Professional evaluation; Surgeon; Public health
• ISSN: 0090-0036; 1541-0048
• DOI: 10.2105/AJPH.87.10.1645

This study assessed the validity of surveys for identifying the best coronary artery bypass surgeons. Data on physicians who performed coronary artery bypass surgery were available from New York, Pennsylvania, and Wisconsin. Data on physicians' reputation were obtained from one national and five city surveys. The measure of surgical performance was the mortality ratio (MR), that is, the ratio of the observed to the predicted patient mortality rate. Mortality ratios were very similar for the 10,722 patients treated by the 31 surgeons defined as "best" doctors in the surveys (MR = 98) and for the 74,854 patients treated by 243 other surgeons who had more than a minimal number of cases (MR = .96). The mortality ratio was 1.34 for the patients treated by surgeons with the lowest volumes and .87 for the surgeons who performed more than 400 coronary artery bypass surgeries in 3 years. These results suggest that the quality of a coronary artery bypass surgeon may be more closely associated with patient volume than with the surgeon's reputation among peers.