Surgeon league tables under the microscope

Sarah Wiedersehn

The use of surgeon "league tables" in Australia will be debated among a large meeting of medical professionals.

British cardiothoracic anaesthetist Andrew Klein will on Thursday tell the annual scientific meeting of the Australian and New Zealand College of Anaesthetists that the performance data of 5000 surgeons in the UK has been publicly available as part of a government campaign since 2014.

Dr Klein said while the publication of the data by the National Health Service had been controversial, it was a useful tool for patients and their families.

In the UK, surgeon performance is measured against a set of professional standards such as patient survival rates and the number of operations performed.

"There is no doubt that some surgeons believe the publication of this data is unfair because they may stop getting referrals, but the availability of this information can have very important implications for patients and patient choice," Dr Klein, chairman of the Department of Anaesthesia and Intensive Care at Royal Papworth Hospital, Cambridge, said.

The specialist anaesthetist said some surgeons had been stopped from working because of the high mortality rates published by the NHS.

"If it was my mother or my wife or any member of my family, I would want to know which hospital they are going to and details about the surgeon, including their patient mortality rates. For the patient looking at outcomes, if the surgeon has nothing to hide, then it should be published."

A landmark study in 2015 led by Dr Klein examined the effect of 127 surgeons and 190 anaesthetists on the mortality of 110,000 cardiac patients over 10 years at 10 UK hospitals.

Overall, the study found surgeons accounted for four per cent of the risk of death, while the patient's health accounted for 96 per cent of the risk of death.

Dr Klein argues a similar study could be replicated in Australia.

"It would be worthwhile because then you could look at the variability between surgeons and anaesthetists in Australian hospitals to see whether there are any noticeable differences and then see if it should be reported in the public domain."