Publishing performance data is an ethical obligation in all specialties

The problem of "gaming" cardiac surgery outcomes by avoiding high risk patients was proposed and investigated at the time of the initial publication of the results and no evidence was found to support the assertion. 2 More recently it has been suggested that without the knowledge of their own mortality or complication rates and those of their colleagues it is not possible for surgeons to obtain full informed consent from their patients. 3 Thus, complication and death rates become a tool for continuous quality improvement, patient information, and informed consent rather than a stick with which to beat the surgeon.