Comments on: Kossman witch-hunt a study in procedural unfairness

By: george

george — Thu, 01 Jan 1970 10:00:00 +0000

Maintaining quality in medical care and evaluating quality is a difficult challenge. Unfortunately we have no benchmark against which to judge the results here.The claim is 6000 surgical procedures in trauma patients were carried out 24 were evaluated as possibly problematic and 12 were suboptimal . There were no deaths due to treatment and when errors occured they were corrected.Unfortunately this type of audit is not standard for surgeons and so we don’t know if these results represent surgical excellence or are below average.It is not news to medical practitioners that problems due to treatment arise and it is estimated that 100,0000 deaths occur in the US per year due to medical error.I think it is encumbent on the review panel to reference the control group which they have used to decide the outcome here is below par.Unfortunately Although medical students are steeped in science it is often lacking when designing and reporting on uncontrolled clinical trials or audits like this one. Clearly it would be better if no surgeon ever made a mistake and if we had the most experienced surgeon when we needed them in an emergency. In the real world these results may actually be quite good !!!

By: JamesK

JamesK — Thu, 01 Jan 1970 10:00:00 +0000

I agree with Greg Barnes. The nature of this inquiry is what is disturbing. Unfortunately, because of the many problems alluded to by Barnes particularly the media most especially the disturbing sight of the senior orthopoedic specialist retired surgeon (Bob Dickens) and head of the inquiry fronting the media yesterday to further denounce Kossman alongside the CEO of The Alfred, Jennifer Williams, doubt will now forever exist about Kossman and it should not be the case. Furthermore, if Kossman was as bad as Dickens is suggesting how could he have held down such a prominent busy role for 7 years and 7,000 surgical procedures and “got away” with it for so long. Why hasn’t Williams tendered her resignation?

By: James Malone

James Malone — Thu, 01 Jan 1970 10:00:00 +0000

Crickey plays its role of agent provocateur very well and this nstance is no exception. However the point is that surgeons do need to be briilliant. They have a very critical role in maintenance of the community’s health through their permission to undertake very difficult and at times life threatening work on our bodies. Consider the extent of training and testing required to become a qualified surgeon. Whether Professor Kossman is brilliant or not is beyond my capacity to determine and, I suggest, beyond Crickey’s too. I would much prefer to trust the judgement of others in that profession. To dismiss the findings of the inquiry as a demonstration of poor judgement by conservative doctors is just too cute and convenient to support your unqualified opinion. And, no I am not a doctor.

By: Frank Birchall

Frank Birchall — Thu, 01 Jan 1970 10:00:00 +0000

In a serious enquiry of this nature it is essential that “the accused” be given due process in the proceedings of the enquiry. Due process includes an independent “judiciary” and one that is seen to be independent. The make-up of this enquiry clearly fails to meet this test. George’s comment about benchmarks is also very relevant.