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Monday, February 7, 2011

In front of the entire class: Surgical success rates

Dr. Harvey Cushing became the father of brain surgery, following his surgical residency at Yale in the late 1890s. He attributed his success to meticulous care, rather than innovations per se. One key to his success was meticulous record-keeping. It started when he was assisting with surgery as a student, using a sponge to administer ether, and the patient died in front of the entire class. Appalled and mortified, Dr. Cushing and a classmate soon developed "ether charts," to keep track of a patient’s heart and respiration rates, perhaps his first major contribution to medicine. Such charting revolutionized surgery by greatly curbing complications and deaths from anesthesia, according to the Journal of Neurosurgery.

Since Dr. Cushing's era, anesthesia is the field of medicine where doctors have most greatly reduced their error rates. The systematic collection of their data and the scrutiny of it by those empowered to change medical practice saved many lives. Doctors in other fields also now record information on their success rates. It's time for this information to become routinely available to consumers. In Massachusetts, a legislative bill to require surgeons to provide some basic information to consumers is under consideration.

Advice: Find out the success rates for your surgery and your surgeon before you go under the knife.

Read another story about such transparency of surgical data. Thanks to Richard Conniff for the source story in the January/February 2011 issue of the Yale Alumni Magazine.

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