My point in bringing up staging and my experience at SCCA was really just to point out that as OG says, it's difficult to assess quality of care and that this is compounded by the fact that the one seemingly objective measure can be manipulated. Knowing whether it is or not is probably impossible: you could dig into an institution's numbers but how would you account for the fact that people with later stage cancers are more likely to seek out institutions with more experience in them?
I don't think the only reason for upstaging in my case was stats. In fact, the associate professor doing the teaching stated quite matter of factly that he'd never had anyone complain about having been given worse expectations and exceeding them. If I see him I guess I'll be the first because the imaginary number created real life problems and I'd have been better off (and one could argue more accurately staged) if they had simply refused to assign a number ahead of a PET, as did all the other doctors I saw.
Some of that comes down to experience fighting with insurance (which is a very significant part of this whole process) and some I chalk up to simple academia. I'm not sure how to further describe that concisely, or if it really has any relevance so I'll leave it at that. All I can say with certainty is that there exists an apparent ethical conflict when an institution's marketing can take advantage of mistakes or a consistent reporting bias.