Cardiac surgeon report cards, referral for cardiac surgery, and the ethical responsibilities of cardiologists.
Public reporting of clinical outcomes data is but one response to calls for increasing transparency in health care. Cardiac surgical operations are among the most commonly performed complex operative procedures. Risk-adjusted cardiac surgery mortality rate data for individual cardiac surgeons are currently available for >25% of the U.S. population as well as for Great Britain and Ireland. Although cardiologists are the primary source of referral of patients for cardiac surgery, surveys of cardiologists and analysis of market share data indicate this information is not being used to refer to cardiac surgeons with the lowest mortality rates. We review the ethical principles that should obligate cardiologists to discuss and use outcomes data, when available, in selecting cardiac surgeons to whom they refer their patients.
Department of Medicine, Stony Brook University, New York, USA. david.brown@sbumed.org
David L
DL
Brown
Stephen
S
Clarke
Justin
J
Oakley
D022126:Access to Information; D006348:Cardiac Surgical Procedures / Q000401:mortality / Q000592:standards; D016265:Conflict of Interest; D004992:Ethics, Medical; D017052:Hospital Mortality; D006801:Humans; D028681:Moral Obligations; D017063:Outcome Assessment, Health Care; D010820:Physicians / Q000941:ethics*; D011787:Quality of Health Care; D012017:Referral and Consultation / Q000941:ethics*; D012941:Social Responsibility