Choosing a good surgeon will enhance your chances of avoiding the unpleasantness, risk, and cost of unnecessary surgery; help ensure the right surgery is performed; and improve your chances of obtaining positive short- and long-term results and having a relatively hassle-free experience.
To help you make your choice, this website tells you for each of the types of surgery we report on:
Which surgeons' results were better or worse than average according to the data we had available and our methods of analysis.
Our researchers analyzed millions of Medicare fee-for-service claims records over a five-year period. We report for each surgeon a number of stars based on (1) how confident we can be that the surgeon's outcomes were different from average as a result of more than chance (luck) alone and (2) how the surgeon's risk-adjusted outcomes ranked compared to the outcomes of other surgeons. We looked at two types of outcomes to the extent we could identify them from the data we had–
- How often the surgeon's patients died in hospital or within 90 days after discharge.
- How often the surgeon's patients had any or several types of bad outcomes:
- Deaths in-hospital or within 90 days of discharge; or
- Prolonged stays in hospital, which we identify as indicators of complications ranging from staph infection to stroke to acute renal failure; or
- Readmissions to a hospital within 90 days after initial discharge following surgery; which readmissions might result from problems ranging from pneumonia to gastrointestinal obstructions to post-operative infections; and which problems might result from poorly performed surgery, poor care in the hospital, lack of proper arrangements for care after hospital release, or various other factors, many of which good surgeons can help prevent.
In an effort to reduce the likelihood that differences come about because some surgeons treat more difficult cases, we made some adjustments based on such factors as the ages and medical conditions of each surgeon's patients. Surgeons receive the following ratings based on our definitions, methods, and analysis of the cases we used/studied from a set of five years of Medicare hospital records (see also "Advice & Explanations"):
Five stars indicates that, using our analysis methods, a surgeon has met two criteria (1) based on the surgeon's outcomes and number of cases, we can be at least 95 percent confident that his/her better-than-average outcomes were not just the result of good luck; and (2) the surgeon's outcome rates were among the best 1/5th of all surgeons studied.
Four stars indicates that, using our analysis methods, while the surgeon did not meet our criteria to qualify for a 5 star rating, the surgeon performed better than average and based on the surgeon's outcomes and number of cases, we can be at least 90 percent confident that his/her better-than-average outcomes were not just the result of good luck.
Three and a half stars indicates that, using our analysis methods, the surgeon's outcome rates were among the best 1/5th of all surgeons studied but the surgeon did not have enough cases that we can be at least 90 percent confident that his/her better-than-average outcomes are not just the result of good luck.
Three stars indicates that, using our analysis methods, (1) the surgeons' rates were not among the best 1/5th of all surgeons studied and (2) neither can we be 90 percent confident that the surgeon had better-than-average outcomes that were not just the result of good luck and nor can we be 95 percent confident that the surgeon had worse-than-average outcomes that were not just the result of bad luck.
Two stars indicates that, using our analysis methods, while the surgeon did not meet our criteria to get a 1 star rating, the surgeon's outcomes were worse than average and, based on the surgeon's outcomes and number of cases, we can be at least 95 percent confident that his/her worse-than-average outcomes were not just the result of bad luck.
One star indicates that, using our analysis methods, a surgeon has met two criteria (1) based on the surgeon's outcomes and number of cases, we can be at least 95 percent confident that his/her worse-than-average outcomes were not just the result of bad luck; and (2) the surgeon's outcome rates we calculated were among the worst 1/5th of the rates we calculated for all surgeons studied.
— A dash mark indicates that the surgeon did not have enough of this type of surgeries in the records we were able to analyze to provide a basis for us to report on their outcomes.
How often the surgeon was recommended by other doctors.
We obtained these data when we surveyed all actively practicing doctors in the same region and asked them to name, for each of at least 35 specialties, one or two doctors they "would consider most desirable for care of a loved one." We identify the doctors with a sufficient number of mentions as "Top Doctors" on our GuidetoTopDoctors.org website and have indicated which surgeons on this website are "Top Doctors" by reporting that they were "Recommended Most by Surveyed Doctors."
We have good evidence that for a doctor to be identified in this way by our surveys of peers is meaningful. Obtaining the number of mentions we require for the doctor to be listed as a "Top Doctor" would be very unlikely to happen by chance alone–for example, it would not be expected to happen if the surveyed doctors were randomly naming names. More important, we know that doctors–in particular, primary care physicians–who receive enough mentions to be listed as "Top Doctors" also receive statistically significantly higher patient ratings than other doctors in rigorous surveys about how well the doctors listen, explain things, and relate to patients in other ways. Doctors mentioned often are also more likely than other doctors to be board certified and less likely to have disciplinary actions filed against them by regulators.
Among surgeons, the doctors who receive enough mentions to be listed as "Top Doctors" have, on average, better death rates and rates of "deaths and other bad outcomes" than other doctors in the outcome data we have reported on this website and in the government-reported death rate data available in some states for some types of surgeries. For example, the cardiac and thoracic surgeons listed as "Top Doctors" have a 5.8 percent death rate for heart valve and coronary artery bypass graft (CABG) surgery while cardiac and thoracic surgeons who are not mentioned enough to be listed as "Top Doctors" have a 6.8 percent death rate. Similarly, for major large and small bowel surgery, the death rate for surgeons who are listed as "Top Doctors" averages 11.2 percent, compared to 12.4 percent for surgeons doing these surgeries who are not listed. And for total hip and knee replacement, the "deaths or other bad outcomes" rate for orthopedic surgeons recommended by enough peers to be surgeons listed as "Top Doctors" averages 13.3 percent versus 15.0 percent for surgeons doing these surgeries who are not listed as "Top Doctors."
We believe the doctor recommendations provide insight not only into likely outcomes but also whether other doctors have high regard for a doctor's diagnostic ability, commitment and skill at communicating and coordinating with patients and other doctors, and ability to obtain results that improve patients' quality of life. In fact, most doctors rely heavily on other doctors' recommendations when selecting cardiac and thoracic surgeons for themselves or their family members.
Keep in mind, however, that we conduct these surveys of doctors about other doctors only in 53 of the largest U.S. metro areas, and that while some regions have been surveyed within the last year or two, some have not been surveyed for more than seven years. So a doctor might not be listed as recommended by other doctors if he or she is new to a region or we did not survey in that doctor's region (you can tell if we surveyed in a region if a number of other doctors from that region are listed).
Whether the doctor is board-certified and in what specialty.
These data are from the American Board of Medical Specialties. To become certified, a doctor must undergo training for a period of years after medical school and pass a test administered by the relevant specialty board. Many doctors must continue to meet educational and other requirements and take tests every six to 10 years (depending on the specialty) to maintain their certification. But that "maintenance of certification" requirement doesn't apply to doctors originally certified more than a certain number of years ago (about 25 years ago for most specialties) because certification was formerly for life. Click here for more information on board certification.
Hospitals the surgeon has used for this type of surgery and whether patients in those hospitals have had very good results.
These are hospitals that have reported that the surgeon performed the specified type of surgery in their hospital from 2010 through 2014 (the most recent data available from the government when we performed this analysis). Choosing a good hospital is important. Click here for our extensive ratings of hospitals. In our ratings of surgeons, we indicate with a checkmark (✓) for each hospital we list as having been used by the surgeon for the specified type of surgery whether the hospital had statistically significantly (with at least a 90 percent confidence level) better-than-average outcomes for the specified type of surgery—looking at any of the same types of bad outcomes described for surgeons above. When considering a surgeon, there is good reason to ask him or her to perform your surgery at a hospital that achieves the best outcomes.
Surgeon's medical school and year of graduation.
You might want a surgeon who graduated many years ago and has had a great deal of experience. Or you might prefer a more recent graduate who may be more up-to-date on recent developments and is more likely to be available if you need him or her in the years to come. Most consumers don't know much about the standards and quality of medical schools, but a well-known university might provide some reassurance. Also, it is worth noting that medical schools in the U.S. are acknowledged to be of high quality, as are schools in some other countries such as Canada, the U.K., Switzerland, and Belgium.
Where the surgeon received post-medical school internship and residency training.
Many experts say that where doctors receive post-medical school training is more important than medical school. You may recognize well-known, high-quality hospitals in these listings. You can get our ratings of hospitals here. For information on post-medical school training, we have relied on data from the American Board of Medical Specialties, which is authoritative but not complete for all doctors.
Whether the surgeon had experience performing a relatively large number of procedures in specified procedure groups.
The "Yes" or "No" shown here reflects counts of surgeries only for Medicare patients and only in 2013-2014, the most recent two years for which we have data.
There is much evidence that experience matters. And all of the surgeons listed on this website have done a substantial number of procedures in 2010-14. Otherwise we would not have had enough basis to report meaningful outcome results. So you can be confident that those doctors with stars had a substantial number of cases. A "Yes" reported here is an extra plus, indicating that the surgeon not only has substantial experience but has even more than most others listed. Keep in mind that experience matters more at the low end. For example, for many procedures, performing 10 per year compared to five is more important than performing 100 per year compared to 50.
For additional explanation, see More About Our Data.
Beyond using our data, applying your own judgment based on face-to-face interactions with a surgeon can be very important for choosing the surgeon who will actually do your surgery. For things to look for in those interactions, see Getting the Best Care.