BMJ  2004;329:450-454 (21 August), doi:10.1136/bmj.329.7463.450

Education and debate

The legacy of Bristol: public disclosure of individual surgeons' results

¹ Society of Cardiothoracic Surgeons of Great Britain and Ireland, Royal College of Surgeons of England, London WC2A 3PE, ² The Limes, Charfield, Wotton-under-Edge GL12 8SR

Measurement of outcomes from medical or surgical interventions is part of good practice, but publication of individual doctors' results remains controversial. The authors discuss this issue in the context of cardiothoracic surgery

The first 150 words of the full text of this article appear below.

Introduction

After the General Medical Council hearings and the subsequent Bristol Royal Infirmary Inquiry into paediatric cardiac deaths, cardiac surgeons expected a stinging attack on British cardiac surgical practice. What emerged instead, in 2001, was a comprehensive report highlighting many of the difficulties facing frontline clinicians and managers in the NHS.¹

The story of the paediatric cardiac surgical service in Bristol is not an account of bad people. Nor is it an account of people who did not care, nor of people who wilfully harmed patients. It is an account of people who cared greatly about human suffering, and were dedicated and well-motivated. Sadly, some lacked insight and their behaviour was flawed. Many failed to communicate with each other, and to work together effectively for the interests of their patients. There was a lack of leadership, and of teamwork. It is an account of healthcare professionals who were victims of a . . . [Full text of this article]

Why publish results on individual surgeons?

The national service framework for coronary heart disease

Can crude mortality be usefully presented?

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Would this have worked?

Kevin E Pearce
bmj.com, 22 Aug 2004 [Full text]

Professional and organizational accountability required for report cards.

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bmj.com, 28 Aug 2004 [Full text]

public disclosure of individual surgeons' results

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