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Public reporting of surgeons’ performance

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Without comprehensive audit, it will remain difficult to highlight problems leading to poor surgical outcomes

In November 2012, the medical director of the United Kingdom National Health Service (NHS) announced that within 2 years, league tables showing performance data for surgeons working in the NHS in England would be published.1 The aim of this was to expose “variation and unacceptable practice” by publishing the results of “consultant-led” teams.2 While Australian national statistics in relation to diseases treated surgically (eg, cancer, trauma), associated complication rates, such as postsurgical infection, and mortality rates are generally as good as in comparable health systems, great improvements can still be made.3

However, the announcement from the UK has again raised concerns within the profession of the value and dangers of such audit programs. If reporting were introduced that focused purely on mortality then surgeons may avoid higher-risk patients. Risk adjustment of outcome can be conducted, but this is by no means a perfect science.4 Individual surgeons within hospitals or regions…