“This is the first time California has ever reported the surgical mortality results for individual doctors. It will help patients choose better surgeons and a better hospitals, and will provide an incentive to improve quality care.” (Dr. David Carlisle, Director, Office of Statewide Health Planning and Development)
As of this month, California residents can now learn the names of both hospitals and surgeons that score higher or lower, when it comes to cardiac bypass death rates.
The Office of Statewide Health Planning & Development, which compiles statistics, now publishes coronary bypass death rates for 300 cardiac surgeons working at 120 hospitals. That’s the good news. The bad news is the most recent information covers surgeries performed in 2003-2004. In other words, the information is 14 years old.
The study was ordered by the California state legislature in 2003 and cost just under $2,000,000. It revealed that while 95% of California heart surgeons scored at, or about the expected, mortality average of 3% patient deaths, some performed considerably better, and some measurably worse. As an example, Doctor Alexander Giritsky at La Jolla Scripps Memorial, was one of only 4 surgeons with the lowest heart bypass mortality rates. Not one of his 126 surgical patients died.
On the other end of the scale, Doctor Jeffrey M. Rosenburg and Doctor Leland B. Housman were among the 12 physicians with the highest patient death rates. Rosenburg operated on 12 patients – 3 of whom died. Housman performed surgeries at Scripps Mercy in San Diego. Rosenburg operated at Palomar Medical Center Escondido. Housman operated on 140 patients – 9 of whom died during the reporting period.
By contrast, at Arcadia Methodist Hospital, a surgeon named Ismael Nuno tallied just under a 90% patient death rate.
About 400 patients each week undergo bypass surgery in California. Called a “cabbage” behind closed doors, the CABG procedure normally involves taking a blood vessel from the chest or leg and using it to create a new route for blood flow within the heart. 50% of these procedures are done on emergency patients.
It is important to note that dire surgical outcomes ought not be laid solely at the feet of the physicians. Some surgeons are quick to point out – and rightfully so – that their statistics are skewed from the start, because they are treating extremely sick patients to begin with, whose chances of surviving – especially in an emergency – are poor at best. Doctor Housman said it very well. “They died mainly because I accepted a mix of people who were older and sicker than most other surgeons are willing to take.”
Here’s another look: