Report Cards on Cardiac Surgeons — Assessing New York State's Approach

Abstract
Publication of “report cards” on hospitals and surgeons is an important new trend.1 The New York State Department of Health pioneered this practice by developing the Cardiac Surgery Reporting System (CSRS), which generated the first physician-specific mortality report ever published.2 This controversial report and its annual updates have received intense publicity, because the results indicated that the percentage of patients who died after heart surgery differed widely among surgeons, even after adjustment for differences in the patients' attributes.3,4 In addition, risk-adjusted death rates for coronary-artery bypass grafting (CABG) reportedly declined in New York after CSRS had been implemented, leading . . .