Consumer Reports, collaborating with the Society of Thoracic Surgeons, today published its list awarding one, two, or three stars to surgical practices that agreed to share their performance data on patient survival, surgical complications, and adherence to guidelines on medication use and other care.
Four groups in Massachusetts -- doctors affiliated with Boston Medical Center, Massachusetts General Hospital, Mount Auburn Hospital, and North Shore Medical Center -- earned the highest rating. They are among 50 groups across the country to merit the above-average designation. Surgeons who operate at Baystate Medical Center in Springfield and St. Vincent Hospital in Worcester won two stars for average performance. No group in the state was among the five nationwide that ranked below average, but only six Massachusetts groups agreed to be part of the Consumer Reports list.
While 90 percent of the country’s more than 1,000 cardiac surgery groups submit data to the thoracic surgery organization, only 221 groups from 42 states and the District of Columbia took part in the Consumer Reports ratings. The society has been collecting information about heart bypass surgery since 1989, the same year that New York state required cardiac surgeons to report on their performance.
Since 2002, Massachusetts has measured how well hospitals do on bypass surgery and on other heart procedures, such as opening up blocked blood vessels with angioplasty or stents. In a commentary published today in the New England Journal of Medicine, Dr. Timothy Ferris and Dr. David Torchiana of Mass. General say such public reporting is essential to improving patient safety, pointing to the suspension of a cardiac surgery program based on such data. They do not name the hospital, but UMass Memorial Medical Center in Worcester shut down its cardiac surgery program for six weeks in 2005 after state data showed its patients were dying at rates that were significantly higher than the state average.
Like the Massachusetts report card, the Consumer Reports rankings take into account how sick or old the patients are in an effort not to penalize surgeons or hospitals that care for people who are at greater risk. Unlike Massachusetts, individual surgeons are not graded by Consumer Reports, but their names are included with their groups.
"Nonparticipating cardiac surgery programs will come under pressure to allow the outcomes in their programs to be reported," the Mass. General doctors say in the New England Journal. "Physicians in other surgical specialties that are amenable to this kind of approach, such as orthopedics or vascular surgery, may be expected to follow suit."