Letter to the editor: State ranking system flawed
May 6, 2013
I am a proponent of public reporting and transparency in medicine but sometimes statistics and rankings can be misleading. This is the case with Dr Freyaldenhoven and his ranking as one of the bottom five cardiac surgeons in the state.
As a busy cardiologist, I can tell you first hand that he is an outstanding cardiac surgeon and doctor. I would not hesitate to have him operate on me or a loved one. He is one of the few cardiac surgeons I have met throughout my career who will do whatever is best for the patient in each situation regardless of surrounding circumstances.
He is willing to take on cases that other cardiac surgeons, including his partners, decline or refuse. In doing so, he will accept a patient who is facing certain death without a high risk operation but may have a 50-50 chance of survival with the procedure. I have personally referred him several such patients and he has saved many lives by accepting them. He does so regardless of insurance coverage, social status, or other factors. In doing so, he risks his statistical reputation and “ranking.”
Yes, the statistics are supposedly “risk adjusted” but there is no way to accurately risk adjust the cases Dr Freyaldenhoven accepts. In addition, many hospitals are well aware of the risk adjusting model and game the system to make all of the routine cases appear as high risk as possible. This is why I finding it ironic that French Hospital could be ranked as low as it is in the state while Marian Hospital has the same cardiac surgeons perform its operations and was ranked much higher. This clearly shows the inexact methods and flaws in the ranking system.
So, while the report published by Cal Coast News earlier is factual, I find it very unfortunate because it does not tell the complete story and will make it unlikely that good cardiac surgeons like Dr Freyaldenhoven will continue to be willing to accept these high risk patients for potential lifesaving operations. It would be a tragic loss to the central coast if Dr Freyaldenhoven is forced to decide who to offer an operation to based upon his concern for his ranking within the state. I hope no one ever has a friend or loved one dying and in need of a potential lifesaving cardiac operation but is unable to find a surgeon to accept the case because the surgeon is afraid of being publicly belittled later for having poor outcomes.
Alex Harrison, M.D., is a board certified cardiologist serving the community of Santa Maria.