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The Problem with Outcome Metrics or The VIP Syndrome or Why Bill Clinton is Alive and Steve Jobs is Not.

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A recent debate on using transplant center outcomes to decide accreditation with insurance and reimbursement reminded me of this article I had written on Quora some time ago. Copied and pasted. Upvote 20 Downvote Comments 2 Why Bill Clinton is alive and Steve Jobs is not Vinay Kumaran , Liver Transplant Surgeon Posted Dec 28, 2015  ·  Vinay Kumaran's Posts Transparency, the intention to treat and analysing data. or Why Bill Clinton is alive and Steve Jobs is not . How do you select a surgeon or a Hospital? How, assuming you are sufficiently rich and powerful that you want the "best in the world", do you find the best (or hire the best finder to find the best)? If you need a liver transplant, you can go to a website called  SRTR -- Scientific Registry of Transplant Recipients . At this website, you can look up the mortality, one-year survival, five-year survival, waiting list mortality and other such statis

Took some time to find but I had to save this

This answer on Quora was collapsed within 18 hours but it still became one of the most popular ones on the topic. Not only is the answer collapsed but the author is also banned from Quora but this is a perfect illustration of why he was banned. Tissues (paper products) Toilets Culture of India +2 Will Indian toilets ever switch to toilet papers? Westerners believe that tissues are hygienic, and Indians think otherwise. Will it eventually change? Vinay Kumaran , Liver Transplant Surgeon Answered Mar 7 Doctors have a unique opportunity to test the efficacy of the two methods. Having worked in India as well as the US and having performed rectal examinations of patients from both places, I can tell you that there is no contest. All American arseholes (and presumably British ones), on close examination, have an appreciable residue of dried faecal matter on the perianal skin. Presumably, this eventually finds its way into the bath water when they

Flippers

I moved from New York to Pittsburgh in 2004 to start my fellowship in Transplant Surgery. While I was looking for an apartment to stay in, I received advice from friends and colleagues: "buy a house instead of renting. Instead of paying rent, you can pay EMIs on the house and when you move, you can sell the house for more than you bought it for. The price of property always goes up." Fortunately I did not heed the advice and we know what happened in 2007-2008. It has long been thought that the reason for the financial crisis was banks giving loans to people who could not afford the properties they were buying with the loans. Bank employees received incentives according to the number of loans they could negotiate. It was in their interest to negotiate loans for more and more people and when they ran out of people with good credit histories who could afford to pay back the loans, they turned to people with poor credit histories who could not. Incomes were falsely stated and