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May 30, 2008
BehindTheMedspeak: 'The public has no idea of the extent of difference between top surgeons and bad ones'
Dr. Frederic H. Moll, founder of Intuitive Surgical — which now dominates the field of of robotic surgery — and CEO of Hanson Medical, a publicly traded robotics company focused on minimally invasive cardiac care, quoted by Barnaby J. Feder in a May 4, 2008 New York Times Business section front page story about the booming field of robotic surgery.
Moll continued, "Robots are good at going where they are supposed to, remembering where they are, and stopping when required."
For now, anyway.
Moll is spot-on about the range of surgical capability displayed by my colleagues on the other side of the drape.
Is there as much variability, say, in anesthesiology or radiology or general practice?
Probably — but the evidence is far less obviously and immediately evident.
May 30, 2008 at 12:01 PM | Permalink
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The "public" needs to look at board certification and acceptance in professional societies. There are no other objective measures that are reliable.
Posted by: M.D. | Jun 17, 2008 2:56:05 AM
Ok, then, how does an intelligent layperson go about ensuring that he's got a competent doctor or surgeon given high variance in competence as viewed by professionals?
Hanson at Overcoming Bias http://www.overcomingbias.com/2007/09/medical-quality.html discusses the difficulty in getting statistics that could form the basis for a rational decision.
I encountered the same thing while trying to choose an obstetrician. Our midwife recommended one guy because he's nice; I told her that I didn't care about whether the guy was nice, I wanted the guy who'd know how to untangle an umbilical cord if there were an emergency. She seemed a bit shocked. She was more shocked when I asked for statistics. You'd think it would be dead simple: get a measure of the frequency of adverse events corrected for underlying risk (so that the expert who takes on all the really really dangerous pregnancies isn't penalized for having higher adverse event rates). It's barely possible to get straight averages, never mind to ask folks to incorporate a bit of Bayesian updating. Reframed the question as "Which obstetrician would you choose for yourself if you knew that you were going to have a difficult pregnancy" and we got a decent recommendation. All went well and we'd stick with the same doctor again next time round, but I'd really have liked to have been able to be more sure about my decision.
You're the expert: how should a non-expert decide?
Posted by: Eric Crampton | May 30, 2008 8:18:08 PM
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