A ProPublica analysis of nearly 17,000 surgeons finds stark differences in complications rates for some of the most routine elective procedures
In February 2012, LaVerne Stiles went to Citrus Memorial Hospital near her home in central Florida for what should have been a routine surgery.
The bubbly retired secretary had been in a minor car accident weeks earlier. She didn’t worry much about her sore neck until a scan detected a broken bone.
The operation she needed, a spinal fusion, is done tens of thousands of times a year without incident. Stiles, 71, had a choice of three specially trained surgeons at Citrus Memorial, which was rated among the top 100 nationally for spinal procedures.
She had no way of knowing how much was riding on her decision. The doctor she chose, Constantine Toumbis
, had one of the highest rates of complications in the country for spinal fusions. The other two doctors had rates among the lowest for postoperative problems like infections and internal bleeding.
It’s conventional wisdom that there are “good” and “bad” hospitals — and that selecting a good one can protect patients from the kinds of medical errors that injure or kill hundreds of thousands of Americans each year.
But a ProPublica analysis of Medicare data found that, when it comes to elective operations, it is much more important to pick the right surgeon.
Today, we are making public the complication rates of nearly 17,000 surgeons nationwide. Patients will be able to weigh surgeons’ past performance as they make what can be a life-and-death decision. Doctors themselves can see where they stand relative to their peers.
The numbers show that the stark differences that Stiles confronted at Citrus Memorial are commonplace across America. Yet many hospitals don’t track the complication rates of individual surgeons and use that data to force improvements. And neither does the government.
A small share of doctors, 11 percent, accounted for about 25 percent of the complications. Hundreds of surgeons across the country had rates double and triple the national average. Every day, surgeons with the highest complication rates in our analysis are performing operations in hospitals nationwide.
Subpar performers work even at academic medical centers considered among the nation’s best.
A surgeon with one of the nation’s highest complication rates for prostate removals in our analysis operates at Baltimore’s Johns Hopkins Hospital, a national powerhouse known for its research on patient safety. He alone had more complications than all 10 of his colleagues combined — though they performed nine times as many of the same procedures.
By contrast, some of the nation’s best results for knee replacements were turned in by a surgeon at a small-town clinic in Alabama who insists on personally handling even the most menial aspects of each patient’s surgery and follow-up care.
ProPublica compared the performance of surgeons by examining five years of Medicare records for eight common elective procedures, including knee and hip replacements, spinal fusions and prostate removals.