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Physician Quality Ratings Imperfect, But a Start

Margaret Dick Tocknell, for HealthLeaders Media, March 30, 2011

A few years ago I moved from my long-time home to a new city. As anyone who has ever relocated knows, settling in is a process that extends well beyond the arrival of the family furniture. There are schools to consider, restaurants to find, churches to join and friends to make.

To find our dentist, doctors and vet we did just like we did at our former home—we asked our friends and neighbors.

I will admit that not once did I consider looking at any of the physician ratings so proliferate on the Internet. Because I write about healthcare I knew that insurers were busy developing and introducing their own grading systems to guide members to “high quality” and “cost-efficient” physicians but I did not check on those either.

I know what I am looking for in a physician. Top on the list: Listens to me. There probably is not an effective quantitative method to measure that. And that is the root of the problem many physicians have with profiling or rating systems. From New York to California physicians have countered that the quality assessments are faulty and are really just a way for insurers to favor lower cost physicians over more expensive ones.

Payers have been dipping their toes into the profiling pond for several years now. The first efforts were more or less PR disasters for the health plans with the programs in Tennessee and Texas put on hold while state medical associations and Payers worked out the details.

But with all of the recent finger pointing regarding the high cost of healthcare, payers have persisted and developed some sophisticated models to assess their high volume physicians in terms of quality patient care.

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1 comments on "Physician Quality Ratings Imperfect, But a Start"


aweiss (4/3/2011 at 8:53 AM)
No disagreement with what you say here, but consumers don't have to rely solely on health plan efforts (which aren't very transparent and can yield different results for the same physician). There are many community- or even state-based efforts, such as those sponsored by the Robert Wood Johnson Foundation's Aligning Forces for Quality initiative, that offer physician and hospital performance rating with other useful content about health and health care, and that are connected to efforts to help providers improve care and to engage consumers as well.