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[–] Digik 0 points 1 point (+1|-0) ago 

I agree, but think we still have to try to define something. For one, to measure, could you separate out the primary reason for a surgery from common complications (e.g. post-surgery infection rates...). Or group performance ratings between common levels of difficulties... physicians into front line care and second and third level experts (those physicians that get referred to from other doctors when they hesitate to take on a problem...)