Is perfection in medicine really the best thing?

Public demand for a zero percent death rate in surgery may have unintended consequences:

Dr. Thomas H. Lee knows the headline he wrote is provocative: “Is Zero the Ideal Death Rate?”

But the network president of Partners Health Care and associate editor at the New England Journal of Medicine is concerned that public reporting of mortality rates for individual cardiac surgeons carries unintended, perverse consequences. He fears that surgeons might hesitate to operate on high-risk patients if they are seeking a perfect performance record, he and two colleagues write in tomorrow’s issue of the journal.

“If you are being ranked, you may walk away from a patient who’s very sick, even though that patient may be at high risk for surgery but even higher risk with medicine” as treatment, he said in an interview. “When so few patients can swing things for you being ranked, we’re worried about that effect on the decision-making process.”

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