Measuring Physician Quality
The Internet has made it possible for us to weigh in and share our opinions on just about everything we purchase or experience. Others' ratings of quality, service delivery, price, and value help us evaluate our options when we make purchasing decisions.
It makes sense then that we'd expect to also rate our healthcare providers. As you might imagine, however, measuring physician quality is a bit more ambiguous than recommending the book you just purchased online.
Currently, numerous government agencies and independent organizations are developing appropriate healthcare quality measures and dispersing the results to would-be patients.
Patients, clinical experts, insurance companies, and social service agencies (such as Medicare) all have an interest in measuring physician quality. Each group relies on different evaluation criteria, which makes this endeavor particularly challenging. Furthermore, quality healthcare measures are often hard for consumers to understand or are simply not meaningful to patients.
As a recent study illustrates, even when consistent and meaningful evaluation criteriaare used, the results are still questionable. Massachusetts General Hospital and Harvard Medical School found that who doctors care for could influence pay-for-performance rankings. Physicians caring for patients who were underinsured, didn't speak English, or belonged to a minority group received lower rankings than their peers. When the researchers adjusted for these patient demographics, the physicians' ratings improved.
The experts who serve on the President's Cancer Panel are grappling with defining indicators of quality in cancer care. Healthcare quality is multi-faceted and includes who is delivering care (such as a hospital or physician), how they are delivering care, and important outcomes (for example, survivorship, patient functionality, quality of life, and satisfaction of care). Furthermore, delivery of the right care to the right patient depends in part on the effectiveness of the communication between patients and physicians who use the information to make care decisions.
The implications of measuring healthcare quality are staggering. For example, the 13th Annual HealthGrades Hospital Quality in America study (October 2010) found that patients treated at 5-star rated hospitals had a 72 percent lower risk of dying than those treated at 1-star rated hospitals. This equates to 232,442 Medicare lives that might have been saved during the three-year study period (2007 to 2009).
For now, patients who want data that measures physician quality can turn to HealthGrades, an independent healthcare ratings organization. You can search HealthGrades' database of 75,000 physicians to see how other patients rated your physician and even add your own ratings.
Hong, Clemens S. MD, MPH, Atlas, Steven J. MD, MPH, Chang, Yuchiao PhD, Subramanian, S.V. PhD, Ashburner, Jeffrey M. MPH, Barry, Michael J. MD, and Grant, Richard W. MD, MPH. "Relationship Between Patient Panel Characteristics and Primary Care Physician Clinical Performance Rankings." JAMA 304(10) (2010): 1107-1113. Web. http://jama.ama-assn.org/cgi/content/abstract/304/10/1107
HealthGrades.com. Web. http://www.healthgrades.com/
National Cancer Institute. Division of Extramural Activities. "Defining Quality for Cancer Care." Statements from the President's Cancer Panel Meeting. Web. http://deainfo.nci.nih.gov/advisory/pcp/archive/pcp0498/23apr98stmt.pdf
Stanton, Terry. "What's the measure of physician quality?" AAOS Now. October 2010. Web. http://www.aaos.org/news/aaosnow/oct10/clinical3.asp
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