Doctor 'Report Cards' Not Last Word on Physician Performance

MONDAY Sept. 13, 2010 -- Public information about U.S. doctors' education, certification and malpractice claims may not be enough to help patients determine whether a physician provides high-quality care, a new study suggests.

"To improve the quality of care received by their beneficiaries, some health plans use physician report cards and tiered physician networks to steer their members towards physicians who provide high-quality care. However, most patients do not have access to physician quality measures," wrote Rachel O. Reid, of the University of Pittsburgh and colleagues.

"Patients are therefore encouraged to use publicly available proxies for clinical performance when choosing a physician. The Agency for Healthcare Research and Quality advises patients to consult state medical boards and to seek information on board certification and training as a way to assess the quality of care physicians provide."

In this study, the researchers analyzed claims 2004-05 data from 1.13 million adult patients to calculate performance scores of 10,408 Massachusetts physicians. They then gathered information about the same doctors from the Massachusetts Board of Registration in Medicine.

They found that higher performance scores were associated with three characteristics: being female, board certification, and graduation from a domestic medical school. However, the researchers said there's little evidence to suggest that a patient would consistently receive better quality care by having a doctor with these three characteristics, noting that the average difference in performance scores for a male, non-certified and internationally trained physician was only 5.9 percent.

They also said they found no significant association between malpractice claims and performance score. This suggests that malpractice claims may have more to do with a physician's communication style and other attributes rather than negligent care.

"In conclusion, we found that individual physician characteristics are poor proxies for performance on clinical quality measures and are not well suited for use as such by patients," the researchers wrote. "Public reporting of individual physician quality data may provide the consumer with more valuable guidance when seeking providers of high-quality health care."

The study appears in the Sept. 13 issue of the Archives of Internal Medicine.

More information

The Agency for Healthcare Research and Quality offers a guide to healthcare quality.

Posted: September 2010


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