Physician Profiling

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The Washington Post published an interesting article today on physician profiling.

In the fight to control healthcare costs, employers and insurance companies are now monitoring physican performance. Using sophisticated computer software to analyze millions of health claims and billing data, doctors are being profiled. Physician profiles are rated and used to direct patients to effective and reasonably priced healthcare.

According to the article:

The trend is in its infancy, but such programs are already in more than 100 insurance industry markets or regions across the country, from entire states such as Massachusetts to metropolitan areas such as Los Angeles. Supporters say the programs have slowed the rate of growth of insurance premiums by 3 to 6 percent in their first year.

However, such data-driven scrutiny is raising questions regarding the line separating oversite and interference in patient-caregiver relationships.

The effort is more about cutting costs than raising quality, some say, adding that doctors could begin to “cherry pick” healthier patients whose problems are less costly to treat. Such systems fail to capture the intangibles of quality, such as a doctor who visits a dying patient at home, critics say.

More importantly, the data, which often contains errors, is difficult for physicians to correct. These inaccuracies can not only damage a doctors reputation but have a significant financial impact.

Regardless of these problems and the controversy surrounding physician profiling, it’s likely that doctor ratings are going to become more widely used. The Wall Street Journal Health Blog citied a doctor at a benefits-consulting firm who believes the future of such physician scrutiny is unavoidable:

“In every industry, consumers have a thirst for performance information,” he tells the Post. “People don’t want to go to a movie or buy a book or buy a car or go to a restaurant without some ability to assess value for dollar. What’s taking place here is inevitable.”

Similar Health 2.0 resources are available online. RateMDs.com offers patients the ability to rate their doctor by scoring three areas: punctuality, helpfulness and knowledge. Along with ratings, users can leave comments. A more in-depth survey is used at DrScore.com, which evaluates patient issues including coordination of care, access to services and appointments, the quality of medical care and the efficiency of the practice.

Both of these websites as well as a number of other resources can be found in the Healthcare Reviews category of the Highlight HEALTH Web Directory.

How do you feel about physician ratings? Do you use any of the resources listed above or something similar?

About the Author

Walter Jessen, Ph.D. is a Data Scientist, Digital Biologist, and Knowledge Engineer. His primary focus is to build and support expert systems, including AI (artificial intelligence) and user-generated platforms, and to identify and develop methods to capture, organize, integrate, and make accessible company knowledge. His research interests include disease biology modeling and biomarker identification. He is also a Principal at Highlight Health Media, which publishes Highlight HEALTH, and lead writer at Highlight HEALTH.