The Choice Matters: Go With the Specialist

An article in The New York Times makes a point that might seem self-evident: Patients fitted with heart devices had fewer problems when those devices were implanted by doctors who had special training. I think this finding is very relevant for devices implanted in other areas of the body, particularly in the brain. Consider this point:

Most implant procedures, about 70 percent, were performed by electrophysiologists, the study reported. The remaining implants were done by other types of cardiologists or other kinds of doctors including thoracic surgeons. The study found that the highest rate of serious complications about 2.5 percent, occurred among thoracic surgeons, who accounted for only 1.7 percent of the procedures reviewed.

Knowing this, if one had the choice, why would you *not* want to have a brain implant done by anyone except a specialist with a long track record of performing that specific procedure? I suspect that it is on this point that the surgeons with the record of excellent results differ from those that are merely very good.

The article also provides a strong argument for the creation of a national electronic medical records system. The findings were based on filings made to a national database created in 1995 when Medicare and Medicaid agreed to paying for more implanted defibrillators. One can only imagine the other bits of hard science to be gleaned from records based on data from millions of eople.