ABSTRACT
Surgeon report cards are aggregations of comparative information about the performance of individual surgeons and surgical units. This chapter considers the strengths and weaknesses of this quality and safety argument for surgeon report cards. It sets out the argument in greater detail and examines several objections that have been levelled against it. Surgeon report cards have also been thought to improve patient care quality and safety by providing stronger incentives for surgeons to improve their skills. Many surgical specialties have been developing sophisticated surgical audit processes as part of peer review of performance. One of the most common ethical objections to surgeon report cards is the defensive surgery objection. This is the concern that public reporting leads surgeons to avoid operating on high-risk patients because these patients are more likely to have unsuccessful outcomes, which would have a negative impact on a surgeon’s report card.
