The easiest way for a doctor to improve his mortality rate is by refusing to operate on the sickest patients. According to a survey conducted by the School of Medicine and Dentistry at the University of Rochester, the scorecard, which ostensibly serves patients, can also work to their detriment: 83 percent of the cardiologists surveyed said that, because of the public mortality statistics, some patients who might benefit from angioplasty might not receive the procedure; 79 percent of the doctors said that some of their personal medical decisions had been influenced by the knowledge that mortality data are collected and made public. The sad paradox of this seemingly helpful descriptive statistic is that cardiologists responded rationally by withholding care from the patients who needed it most.