The influence of the surgeon on outcome

In discussing the influence of the surgeon on outcome in this chapter, we draw examples primarily from the field of cardiac surgery. Patients undergoing such surgery are, by virtue of their disease, classified as being at high risk. The outcome of cardiac surgery is measured in terms of mortality as well as morbidity. Those working in the specialty have developed a number of techniques to evaluate the surgical risks for individual patients. These include scoring systems and graphical tools which provide a context of inherent risks against which we can interpret the surgeonʹs influence, both positive and negative. After considering possible outcomes and how they might be assessed, we examine potential influence, including personal and institutional factors. Finally parallels are drawn with pilot performance in the airline industry.