Entries for May 2007

If major surgery awaits you, consider yourself a candidate for a respiratory infection or breathing problem in the days that follow–especially, according to the American College of Physicians, if you are 60 or older, if the surgery involves general anesthesia or takes more than three hours, or if you have congestive heart failure. The risk of a postop respiratory problem has been reported to reach 88 percent. That's a number that will make you catch your breath.

"I'm sorry," the doctor said to the patient in the hospital bed. "It's my fault you have to stay another couple of days. I didn't monitor you carefully enough after starting you on that new drug, and you had a severe allergic reaction." A doctor said he was sorry? The patient faints.

Over the years, a fair number of consumers who have consulted our annual America's Best Hospitals rankings have gotten in touch with me (I direct the project) to ask why we don't rate doctors, too. If there were a fair and objective way to do that, we would. But public data that might get at the competence of individual physicians doesn't exist. A handful of states, among them New York and Pennsylvania, post statistics on the Web showing how well surgeons in a particular state perform in a limited number of procedures, such as heart bypass surgery. But that is pretty much it. Even in those states, you won't find assessments of primary-care providers and other doctors, because these caregivers don't do procedures that neatly lend themselves to tabulation and analysis.

It was hard to keep from cringing as I leafed through the results of a physician survey centering on quality of care. They were just released by the American College of Physician Executives, whose members consist mostly of doctors with management responsibilities.

Not so long ago, widely publicized reports put us on notice that when we get medical treatment, chances of a small screw-up–or worse–are far more likely than we would have believed.