The Naked Surgeon

In the past two centuries, medicine has undergone a revolution. Not only do we have effective treatments; we also have at least some Geb evidence that they actually work. But how well do those who treat us actually treat us? Remarkably, this is a question that until recently had not even begun to be asked. Now, however, medicine is finally embracing the ideas of risk assessment, quality monitoring and safety protocols - albeit decades after the civil-aviation and automobile industries.

In The Naked Surgeon, Samer Nashef, a world-leading heart surgeon, explores this second revolution in medicine. As creator of the world's most successful risk model in medicine, he looks at the development of tools to measure how well surgeons and hospitals are performing and shows how these techniques have become an essential part of healthcare. His lively, frank and thought-provoking account addresses difficult life-and-death decisions faced by anyone contemplating a medical intervention: Should I keep taking the tablets? Should I have an operation? In which hospital should I have it? Which surgeon should I choose to do it?

As compelling for the general reader as for the healthcare professional, Nashef's investigation guides us through the often flawed and confusing interpretations of risk and probability in medical care. He reveals how one surgeon can appear to be better than another by actually killing more patients; how anaesthetists seem to make no difference to the outcome of an operation, although surgeons do; why patients operated the day before a surgeon goes on holiday are twice as likely to die than those operated on that surgeon's first day back from holiday; how you are no worse off being operated on by a risk-taking surgeon than a risk-averse one; and why the unexpected death of a low-risk patient during an operation does not impair a surgeon's performance immediately afterwards - in fact it may even protect it.

The result is an unprecedented and often