How can you tell whether your doctor is any good?

On my last night of residency, a friend and I swapped our most memorable stories. We recalled the nights of panic and triumph caring for dozens of critically ill patients, about the day — okay, days — we fell asleep standing up, about the weeks subsisting on saltine crackers and ginger ale.

The conversation turned to a legendary co-resident: He made diagnoses others hadn’t even heard of. He rushed patients to lifesaving procedures at the faintest clinical change. He cajoled specialists to see his patients in the middle of the night.

We estimated he’d tallied more years of life saved than anyone else in our program — far beyond what other doctors could have mustered in the same position. He excelled in the medical equivalent of baseball’s “wins above replacement”: the number of victories that a player helps achieve beyond what would be expected from a substitute.

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