Should Surgeons Keep Score?
I'm astounded at the tenor of comments on this article, which I would expect to find at any site other than this one.  Yes, measuring surgical outcome data and surgeon performance could lead to a variety of complications, perverse incentives, regulatory capture, etc. etc.  All true.But you know what's worse than that?  Having no fucking information about anything.  I'm in the process of trying to find a surgeon to help with an orthopedic procedure, and it is so incredibly frustrating that I have a thousand times as much information on which refrigerator I should buy, or which phone, than about something that will affect my life more intimately than any consumer product ever could.And yes, of course I get that rating a commodity with a fixed function that is used by zillions of people is way more straightforward.  But look, all of these apocalyptic scenarios about brain surgeons who only take trivial cases so they can have a better score on the leaderboard?  I'm just not worried about it.  At all.  Because people are generally proud and want to do better.  Because of the social and professional stigma that would come from such behavior.  Because if you collect a rich dataset, you can account for most kinds of gaming, just as you can do for teacher outcomes, or every other damn thing.But probably most of all because the current state of affairs is so abjectly wretched, and literally any effort at measurement and accountability would be better under every reasonable scenario.