ProPublica has an app for scoring surgeons. The methodology is detailed in a beautifully typeset paper that you may or may not care to read. What you definitely should do though, is google your doctor if you are about to go under the knife.

On a lark, I looked at North Carolina doctors, and picked out the absolute worst-ranked surgeon doing knee replacements in the ProPublica data set. He stuck out because his score was way over to the right, deep inside the red zone. This was a bona fide outlier if I ever saw one. So then I googled the guy. I promptly found this document, from which I learned the following:

  1. If you’re a doctor, up until recently you could have set up in the spine surgery business in North Carolina as follows:
    • get a partner who does the deciding whether a patient needs some vertebrae fused
    • have said partner say sure does, you kidding me?
    • it helps if it is your partner’s professional opinion that a large number of this unfortunate person’s vertebrae need the procedure, as you guys will bill by the vertebra: about $21,000 for the first, about $7,500 for subsequent ones, plus your partner’s flat $10K fee for a reasonable grand total of around $70K
    • should your partner fail to find sufficient vertebrae that qualify, it’s still OK: you can go ahead and up the number as you go along, since the guy is already sedated and you’re in your scrubs anyway.

  2. If you’re stocking up on the kind of kit one uses for this job, consider the medical device whose maker goes the extra mile and supplies you guys with form letters that you can send to injury lawyers, praising the health benefits of what you’re about to do to their clients.

  3. The procedure takes about half an hour of y’all’s time. It’s OK if your patient has Medicare and you only collect about $5K. A pair of doctors of this sort can make a fair living at $10K/hour in North Carolina. Heck, even if you have to split it between three doctors it’s still not too bad.

Now, I’m not saying that this model is still feasible. The North Carolina Medical Board, upon considering the matter, saw fit to suspend the intrepid doctors’ licenses for 18 months, fine them about $85K a head, and duly reinstate them as soon as the affected parties, through counsel, notified the august board that the 18 months were up. The press of the time noted that this was a record fine. The threat of this inconvenience may be enough to discourage this particular way of making a living as a doctor in our state.

But if you’re about to visit Bones’R’Us, wouldn’t you rather know whether the doctors working there may have dabbled in it before?