From the annual meeting of the Society of Thoracic Surgeons in Fort Lauderdale, Fla.
By this summer, the Consumer Reports health Web site will start listing rankings of U.S. surgery programs that do coronary artery bypass grafting (CABG) using a 1- to 3-star system. Selecting a CABG surgeon will become similar to choosing a car or refrigerator.
Even more remarkable is that the program has the full support and cooperation of a major U.S. group of cardiac surgeons, the Society of Thoracic Surgeons. It was partly the Society’s idea, as they reached out to the Consumers Union (the group that publishes Consumer Reports) in early 2009 at a time when Consumers Union was looking to add information like this, said Dr. Frederick L. Grover, a Denver cardiothoracic surgeon and a recent former president of the Society who works on the project.
The Society will use the extensive outcomes data it collects from its members (roughly 1,000 U.S. practices do coronary bypass surgery) and generate ratings for overall performance as well as four specific outcomes (such as patient survival) as a ratio of observed rates versus expected rates, and then assign the star rating. Most practices will get 2 stars, top performing programs will get 3 stars, and the bottom tier get 1 star.
At least in part, surgeons felt pressed into making this move to prevent other groups that issue consumer information from jumping in first with similar ratings of their own, but using public-domain data that the thoracic Society considers less reliable. The Society began getting permission for the data release from its members last September and hopes to have at least 300 of the 1,000 programs on board by March.
Although release of medical performance data to the public isn’t new–Massachusetts, New York, and Pennsylvania have had programs in place for several years–posting the results on a consumer-oriented site such as Consumer Reports and distilling down the information to a simple star rating is novel. It stands to have a major impact on which surgeons have patients knocking on their doors and which ones get shunned. And it’s not just patients who are the potential audience, but cardiologists and primary care physicians, too.
“It will be interesting to see if it changes referral patterns,” Dr. Grover said. It’s hard to imagine it won’t. Who will want their heart cut by a 1-star surgeon if there’s a 2- or 3-star alternative?
—Mitchel Zoler (on Twitter @mitchelzoler)