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Surgeons' reputations skewed

July 18, 2007

Re "State rates heart bypass surgeons and hospitals," July 13

Your article misses part of the story on quality indicators from the Office of Statewide Health Planning and Development. While outcome data is one indicator of a surgeon's performance, it can unfairly skew reputations.

Dr. Ismael N. Nuno, chief of cardiac surgery at Los Angeles County-USC Medical Center, is listed as one of the worst physicians, yet the report's executive summary clearly references the importance of considering that some physicians treat sicker patients than average. What's needed is a better measure of disease severity so Californians can understand how sick some of these patients are. In the absence of such adjustments, the result will discourage surgeons from treating very ill patients for fear of damaged reputations.

The danger is that if no one operates on the sick, they will die without ever having a chance.

ROMAN J. BOWSER

Los Angeles

The writer is executive vice president and chief executive of the Western States Affiliate of the American Heart Assn.

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