Surgical Outcome Registries Would Protect, Empower Patients

Peter Olszewski

Does surgery work? That may seem like an odd question. Of course surgery works, you might think. People have surgery all the time. Doctors wouldn’t perform surgical procedures if they didn’t help, right? Those are reasonable responses, but the fact is that we have no way of knowing how well many different types of surgery achieve their objectives, or even improve the conditions of the patients who undergo the procedures. Individual physicians usually follow the progress of individual patients, but beyond that, almost nobody is formally keeping track of outcomes and making that information publicly available. That means there is no way for a patient who is considering, for example, a heart bypass to quantitatively evaluate whether doing so is a good idea. All they have to go on are their doctor’s recommendation and anecdotal evidence from friends, family, and even strangers writing about their experiences on the Internet. It doesn’t have to be that way. With a little bit of cooperation from surgeons, hospitals, and associated healthcare providers, the technology exists to collect and compile anonymous patient data on surgical procedures from around the country, or even around the world. These clinical registries, as they’re known, already exist for a number of treatment regimens, including a handful of surgical procedures. What alarms us, and should alarm you, is that the healthcare industry is very happy to keep patient outcomes out of public view. As Dr. Martin Makary of the Johns Hopkins School of Medicine pointed out during a recent interview with NPR, if you’re in the healthcare business, no news is good news. That goes for hospitals, pharmaceutical companies, and manufacturers of medical devices. They have no financial incentive to systematically track patient outcomes, whether for a surgical procedure or a drug or a device that already has been approved for sale by the FDA. That participating in a registry costs a hospital around $75,000 per year is just one more reason for them to avoid collecting and submitting their data. As a result, there are relatively few clinical registries in operation, and even those that exist are very stingy about sharing data. Makary, who specializes in a particular type of pancreatic surgery, submitted his patient data to one of these registries, only to discover later that even as a contributor, he could not access the aggregated data when he needed it. Public access is nearly nonexistent. That means each patient is essentially on her own when deciding whether to proceed with a surgical treatment, with little to guide her apart from her trust in her physician and the rest of the healthcare industry. Makary cites the patient registry of the Cystic Fibrosis Foundation as a model of a transparent clinical registry for patient outcomes. In Makary’s estimation, the cystic fibrosis registry has helped to add two decades to the lives of people suffering from that chronic illness. Created more than 50 years ago, it tracks the treatment and progress of CF patients at all healthcare facilities accredited by the Cystic Fibrosis Foundation. Makary told NPR of a physician at Indiana University who informed the doctors on his staff that he would be recording the colonoscopies they performed; their quality scores immediately jumped by 40 percent. That surgeons perform their jobs more carefully when they know they’re being watched is hardly a surprise to the Pennsylvania medical malpractice attorneys at Scartelli Olszewski; we have handled an untold number of cases in which we discovered that doctors and other medical staff cut corners or failed to follow required procedures because they did not believe anyone would notice. A clinical registry is not a video camera, but it can help accomplish the same goal: to put the effectiveness of surgical procedures in the public eye, empowering patients and their families to make informed decisions about whether a given surgery is really their best option. We join Dr. Makary in calling upon the healthcare system to increase transparency and accountability through the use of patient registries and publicly available outcome data. If you or someone you love has been hurt by a medical error, call the Scranton and Wilkes Barre medical malpractice attorneys at Scartelli Olszewski, P.C. today at 877.353.0529. We are here to help.