All Doctors Are Not Created Equal

Doctors are not gods.  They are not infallible, all-knowing deities picked by God Almighty to spread His wisdom to us mere plebes.  Doctors receive a lot of training.  Doctors work long hours and are well compensated for their work.  But doctors are people just like you and me.  Some doctors are better, or worse, than other doctors.  This makes sense as some teachers, mechanics, barbers, chefs, lawyers, etc. are better than others.  

I recently read a seminal article on this topic called “The Health-Care Bell Curve” in New Yorker Magazine.[1]  The article was written in 2004, but the issue remains as important today.  People used to assume the differences among doctors in a particular specialty were insignificant.  Today, we know that assumption is wrong.  If you plotted a graph showing the results of doctors in a specific specialty, you would find a bell curve: a handful of doctors with disturbingly bad outcomes, a handful with remarkably good outcomes, and a great undistinguished middle.

The New Yorker article points to studies in a variety of fields to illustrate the importance of the individual doctor on patient outcomes.  In ordinary hernia operations, the chances of recurrence are 1 in 10 for surgeons at the low end of the bell curve, 1 in 20 for those in the middle, and 1 in 500 for those at the very top.  The 10 year survival rate for patients with treatable colon cancer ranges from 63% to 20%, depending on the surgeon.  For heart bypass surgery, risk-adjusted death rates can vary from 5% to 1% depending on the surgeon, which is no small difference when life or death is at stake.

The healthcare industry does not like to acknowledge the common sense reality that all doctors are not created equal.  Patients, however, should always be aware of this fact.  Advocate for yourself.  Research all you can on the best doctor and healthcare system for your procedure.  We have written about this extensively in the past: see articles here, here, and here.  It is often said that the most important decision you make is the person you choose to marry.  I would offer that a close second is the doctor you choose to provide healthcare for yourself or a loved one.


[1] Gawande, Atul. The Health-Care Bell Curve. The New Yorker (Nov. 28, 2004), available at https://www.newyorker.com/magazine/2004/12/06/the-bell-curve.

Bo Frith