Journal of the American College of Surgeons - Mortality after Elective Colon Resection: The Search for Outcomes that Define Quality in Surgical Practice (blogger's note: or any other cancer surgeries)

Blogger's Opinion: or any other cancer surgeries for those 'deemed' not qualified with this issues having been widely debated over decades but left unresolved, it would be 'enticing' to detail the moral aspects of death ratios/unqualifed surgeons/outcomes (eg. in hindsight - those patients that should have been referred, but were not)

Journal of the American College of Surgeons - Mortality after Elective Colon Resection: The Search for Outcomes that Define Quality in Surgical Practice

Conclusions

Elective colon resection is a safe procedure in both teaching hospitals and nonteaching hospitals, with an impressively homogenous mean mortality rate of 1.56% in teaching hospitals, and 1.38% in nonteaching hospitals. We reject our original hypothesis because the data do not sufficiently discriminate to permit the use of death after elective colon resection as a differentiating quality measure; however, the data do identify individual poor performers. Poor performing institutions/surgeons should seek extramural guidance to improve their outcomes or discontinue performing such operations.

Medicine Must Allow for Customization: A Lesson for Policy-Makers -- and Regulators - Forbes

Blogger's Note: Hartzband and Groopman article previously posted on blog, try searching blog "Forbes"

Medicine Must Allow for Customization: A Lesson for Policy-Makers -- and Regulators - Forbes

"As appealing as it is – as useful as it is – to imagine that there exists a gold-standard way to practice medicine, and a single-best way to approach most human ailments, the reality is considerably more complex and messy, as Hartzband and Groopman’s (continued) critique of so-called “best practices” makes clear.
The heart of their argument is this: “For patients and experts alike, there is a subjective core to every medical decision. The truth is that, despite many advances, much of medicine still exists in a gray zone where there is not one right answer. No one can say with certainty who will benefit by taking a certain drug and who will not. Nor can we say with certainty what impact a medical condition will have on someone’s life or how they might experience a treatment’s side effects. The path to maintaining or regaining health is not the same for everyone; our preferences really do matter.”
This resonates (see here and here), although I’ve also heard distinguished health policy proponents argue convincingly that even if experts can’t agree what is definitely “right,” there can definitely be agreement about a number of ways of practicing medicine that are clearly “wrong,” yet very common – so that while it may be harmful, and disingenuous, to insist upon a single algorithm or best approach, it could be helpful to at least provide clear guidance so that physicians would know to avoid certain therapeutic approaches.
Not only does Hartzband and Groopman’s argument have implications for the current healthcare debate, it also would seem to have significant implications for the way we view medical product regulation..........