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4 - Public reports: putting patients in the picture requires a new relationship between doctors and patients

Published online by Cambridge University Press:  08 August 2009

By
Merrilyn Walton
Edited by
Steve Clarke  and
Justin Oakley
Merrilyn Walton
Affiliation:
University of Sydney, Australia
Steve Clarke
Affiliation:
University of Oxford and Charles Sturt University, New South Wales
Justin Oakley
Affiliation:
Monash University, Victoria
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Summary

Should report cards on surgeon performance be publicly available? Yes, but only if the information is presented in ways that can be easily understood by consumers and patients. The merits of public reports or provider profiles have been constantly debated since their first appearance in the public domain in the early 1990s. Some of the arguments against reporting include the potential to misinterpret data, the lack of clarity about what is counted and the potential the information may have in lowering staff morale. Better consumer choice, greater clinical accountability and improved quality are arguments in support of public reporting. But missing in this debate is the need to prepare and enable patients to make real choices about their doctors or hospitals.

system not designed for patient choice

Many patients lack genuine choices in healthcare either because of the nature of their disease or because the health system is yet to recognize the scope of the informational needs of patients and their obligations to provide it. A redesigned health system is required if patients are to have genuine choice in their healthcare. The way the health system is currently structured and organized relies on patients being passive receivers of their healthcare.

Report cards about surgeons' performance have been available to patients for more than a decade, yet the evidence is that patients rarely use them to choose their surgeons or hospitals (Marshall, 2001; Schneider and Lieberman, 2001).

Information

Type
Chapter
Information
Informed Consent and Clinician Accountability
The Ethics of Report Cards on Surgeon Performance
 , pp. 65 - 75
Publisher: Cambridge University Press
Print publication year: 2007

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References

Applegate, W. (1986). Physician management of patients with adverse outcomes. Archives of Internal Medicine, 2294–52.Google ScholarPubMed
Barr, D. (1956). Hazards of modern diagnosis and therapy – the price we pay. Journal of the American Medical Association, 159, 1452–6.Google Scholar
Baylis, F. (1997). Errors in medicine: nurturing truthfulness. The Journal of Clinical Ethics, 8, 336–41.Google ScholarPubMed
Brennan, T. A., Leape, L. L., Laird, N. M.et al. (1991). Incidence of adverse events and negligence in hospitalized patients: results of the Harvard Medical Practice Study I. New England Journal of Medicine, 324, 370–6.CrossRefGoogle ScholarPubMed
Brennan, T. A., Sox, C. M. and Burstin, H. R. (1996). Relation between negligent adverse events and the outcomes of medical-malpractice litigation. New England Journal of Medicine, 335, 1963.CrossRefGoogle ScholarPubMed
Couch, N. P., Tilney, N. L., Rayner, A. A. and Moore, F. D. (1981). The high cost of low-frequency events: the anatomy and economics of surgical mishaps. New England Journal of Medicine, 304, 634–7.CrossRefGoogle ScholarPubMed
Davis, P., Lay Yee, R., Briant, R., Ah, W., Scott, A. and Schug, S. (2001). Adverse events in New Zealand public hospitals: principal findings from a national survey. Occasional Paper 3, Wellington: New Zealand Ministry of Health.
Dubois, R. and Brook, R. (1988). Preventable deaths: who, how often, and why? Annals of Internal Medicine, 109, 582–9.CrossRefGoogle Scholar
Duckett, S. and Hunter, L. (1999). Health services policy review: final report. Melbourne: Victorian Department of Human Services. http://www.dhs.vic.gov.au/ahs/archive/servrev/servrev.pdf. Accessed 6th October 2004.Google Scholar
Edwards, A. G. and Elwyn, G. (2001). Evidence-based Patient Choice – Inevitable or Impossible? Oxford: Oxford University Press.Google ScholarPubMed
Friedman, M. (1982). Iatrogenic disease: addressing a growing epidemic. Post Graduate Medicine, 71, 123–9.CrossRefGoogle ScholarPubMed
Gawande, A. T., Zinner, M. J. and Brennan, T. A. (1999). The incidence and nature of surgical adverse events in Colorado and Utah in 1992. Surgery, 126, 66–75.CrossRefGoogle ScholarPubMed
Green, M., Farber, N. J. and Ubel, P. A. (2000). Lying to each other: when internal medicine residents use deception with their colleagues. Archives of Internal Medicine, 160, 2317–23.CrossRefGoogle ScholarPubMed
Guadagnoli, E. and Ward, P. (1998). Patient participation in decision-making. Social Science Medicine, 47, 329–39.CrossRefGoogle ScholarPubMed
Hibbard, J. H. and Jewitt, J. J. (1997). Will quality report cards help consumers? Health Affairs, 16, 218–28.CrossRefGoogle ScholarPubMed
Institute of Medicine (2001). Crossing the Quality Chasm: A New Health System for the 21st Century. Washington DC: National Academy Press.
Kapp, M. (1997). Legal anxieties and medical mistakes. Journal of General Internal Medicine, 12, 787–8.CrossRefGoogle ScholarPubMed
Liptak, A. (2004). Death puts spotlight on a doctor and regulators. The New York Times. New York.Google Scholar
Magee, H., Davis, L. and Coulter, A. (2003). Public views on healthcare performance indicators and patient choices. Journal of the Royal Society of Medicine, 96, 338–42.CrossRefGoogle Scholar
Marshall, M. N. (2001). Accountability and quality improvement: the role of report cards. Quality and Safety in Health Care, 10, 67–8.CrossRefGoogle ScholarPubMed
McLamb, J. and Huntley, R. (1967). The hazards of hospitalization. Southern Medical Association Journal, 60, 469–72.CrossRefGoogle ScholarPubMed
Mennemyer, S. T., Morrisey, M. A. and Howard, L. Z. (1997). Death and reputation: how consumers acted upon HCFA mortality information. Inquiry, 34, 117–28.Google Scholar
Millenson, M. L. (2002). Breaking bad news. Quality and Safety in Health Care, 11, 206–7.CrossRefGoogle ScholarPubMed
Novack, D. H., Detering, B. J., Arnold, R., Forrow, L., Ladinsky, M. and Pezzullo, J. C. (1989). Physicians' attitudes towards using deception to resolve ethical problems. Journal of the American Medical Association, 26, 2980–6.CrossRefGoogle Scholar
O'Connor, A. M., Legare, F. and Stacey, D. (2003). Risk communication in practice: the contribution of decision aids. British Medical Journal, 327, 736–40.CrossRefGoogle ScholarPubMed
Peterson, E. D., DeLong, E. R., Jollis, J. E., Muhlbaier, L. H. and Mark, D. B. (1998). The effect of New York's bypass surgery provider profiling on access to care and patient outcomes in the elderly. Journal of the American College of Cardiology, 32, 993–9.CrossRefGoogle Scholar
Romano, P. (2003). Outcomes of Hospital Outcomes Study. Springfield VA: National Technical Information Service.Google Scholar
Schimmel, E. (1964). The hazards of hospitalization. Annals of Internal Medicine, 60, 100–10.CrossRefGoogle ScholarPubMed
Schneider, E. C. and Epstein, A. M. (1998). Use of public performance reports. Journal of the American Medical Association, 279, 1638–42.CrossRefGoogle ScholarPubMed
Secker-Walker, J. and Taylor-Adams, S. (2001). Clinical Incident Reporting. Clinical Risk Management, ed. Vincent, C.. London: British Medical Journal Books.Google Scholar
Spiegelhalter, D., Murray, G. and McPherson, K. (2000). Monitoring Clinical Performance: A Statistical Perspective. Bristol: Bristol Royal Infirmary Inquiry.Google Scholar
Starr, P. (1982). The Social Transformation of American Medicine. New York: Basic Books.Google Scholar
Steel, K., Gertman, P. M., Crescenzi, C. and Anderson, J. (1981). Iatrogenic illness on a general medical practice service at a university hospital. New England Journal of Medicine, 304, 638–42.CrossRefGoogle Scholar
Sweet, M. P. and Bernat, J. L. (1997). A study of the ethical duty of physicians to disclose errors. Journal of Clinical Ethics, 8, 341–8.Google ScholarPubMed
Thornton, H. (2003). Patients' understanding of risk. British Medical Journal, 327, 693–4.CrossRefGoogle ScholarPubMed
Topol, E. J. (1991). Promises and pitfalls of new devices for coronary artery disease. Circulation, 83, 689–94.CrossRefGoogle ScholarPubMed
Topol, E. J. and Califf, R. M. (1994). Scorecard cardiovascular medicine: its impact and future directions. Annals of Internal Medicine, 120, 65–70.CrossRefGoogle ScholarPubMed
US Congress House Sub Committee on Oversight and Investigation (1976). Cost and Quality of Health Care: Unnecessary Surgery, Washington DC: USGPO.
Valana, M. E. and McGlynn, E. A. (2002). What cognitive science tells us about the design of reports for consumers. Medical Care Research Reviews, 59, 3–35.Google Scholar
Vincent, C., Stanhope, N. and Crowley-Murphy, M. (1999). Reasons for not reporting adverse incidents: an empirical study. Journal of Evaluation in Clinical Practice, 5, 13–21.CrossRefGoogle ScholarPubMed
Vincent, C., Neale, G. and Woloshynowych, M. (2001). Adverse events in British hospitals: preliminary retrospective record review. British Medical Journal, 322, 517–19.CrossRefGoogle ScholarPubMed
Weingart, S. N., Wilson, R. M., Gibberd, R. W. and Harrison, B. (2000). Epidemiology of medical error. British Medical Journal, 320, 774–7.CrossRefGoogle ScholarPubMed
Wilson, R. M., Runciman, W. B., Gibberd, R. W., Harrison, B. T., Newby, L. and Hamilton, J. D. (1995). The quality in Australian health care study. Medical Journal of Australia, 163, 458–71.Google ScholarPubMed
Wragg, J. A., Robinson, E. J. and Liliford, R. J. (2000). Information presentation and decision to enter clinical trials: a hypothetical trial of hormone replacement therapy. Social Science and Medicine, 51, 453–62.CrossRefGoogle ScholarPubMed

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