In the 1976 thriller, “Marathon Man”, a sadistic ex-Nazi dentist(Laurence Olivier)  tortures an unknowing grad student ( Dustin Hoffman) to determine the whereabouts of stolen jewels, constanting asking “Is it safe?”.  The line was etched into the annals of celluloid history. It is now reappearing as more and more potential patients are asking whether it is safe to get care away from home.  A few things to remember:

1. Healthcare, whether delivered in the US or somewhere else, is never completely safe. The operating room, a hospital bed or even an outpatient clinic is potentially dangerous under the best of circumstances.

2. In general, the more times a surgeon and the facility where he or she works does a procedure, the better the outcome.

3. While education, credentials, experience and certification are important quality benchmarks, they sometimes do not tell the whole story.

4. Whether in the US or around the world, quality outcomes data are often incomplete or non-existent.

Patients choose doctors for many reasons. A rational decision based on quality data is rarely one of them.