There is a palpable sense of retribution in Martin Makary’s quiet, deliberate voice when he tells of how as a future surgeon he was almost laughed out of his medical school class for taking the time to get a master’s degree in public health. His decision was born out of his love of statistics and, particularly, the statistical science of medical errors. The idea of preventable harm in the operating room seemed like “the perfect application of public health principles of prevention in a highly technical environment.” That background led to an interest in measuring hospital quality and outcomes research. Today, he finds himself perfectly placed in a wide-open field that is suddenly in the spotlight at national surgical meetings and prestigious academic hospitals. On Sept.1, the Department of Surgery launched its Center for Outcomes Research and put Makary in charge. “We are going to build a center where people can go to pose questions from their observations as surgeons and collaborate with mentors in the [Bloomberg] School of Public Health,” says the young assistant professor. “That’s our mission.”

Whereas measures like laboratory tests have traditionally been used to judge the end results of a health care intervention, outcomes research measures how people function after leaving the hospital and their experiences with care—often the things that matter most to patients. Using national databases, Makary is studying the effect of minimally invasive surgery, as well as transplant and vascular surgery, on outcomes, for example. For another grant, he is looking at the safety of surgery in the elderly to see if frailty influences surgical outcomes. There are almost 1,000 patients enrolled, with another year to go.

When Makary isn’t working on his own projects, he’s running the center (he still spends half his time in the operating room, specializing in pancreas surgery and advanced laparoscopy). There is no shortage of interest: Already, several residents and medical students are doing formal course work in public health. “People are hungry for this stuff,” says Makary. “It’s amazing.”

One of the center’s main initiatives is participation in the National Surgical Quality Improvement Program. Led by the American College of Surgeons, the program tracks patient outcomes nationally, then makes the data available so that areas of improvement can be quickly identified and fixed. There are about 100 participating hospitals nationwide.

Among its services, the center will offer biostatistical and grant support and is also creating forums for those who want to collaborate on specific topics; groups already exist on quality-of-life and foregut issues, national databases and Medicare policy. It will also create a conceptual database library, bringing together the nation’s big databases, and aid people on how to make queries. “We as doctors tend to have the great clinical questions, but these obstacles sometimes prevent us from doing great work, especially when we’re taking about busy surgeons. The goal is to eliminate some of these barriers.”

Makary does not believe in doing research for the sake of producing research, and he clearly would like to make an impact with his work some day. “Traditionally, surgeons have not been politically active,” says the Washington, D.C., resident. “They’ve focused on what they do best, like operations. Now we’re realizing that unless we voice our concerns, Medicare will continue to be cut every year, there will be no hope for malpractice reform, and we’ll have more and more formalized policies and procedures that are handed to us and not developed from within our field. Those are some of the areas I’m passionate about, and I hope they’ll fuel some of the project ideas the students run with.”