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Report: Most States Do A Poor Job Informing Consumers About Physician Quality

By Julie Appleby

December 10th, 2013, 6:28 AM

When it comes to providing consumers with easily accessible information about physician quality, a report out today gave most states grades of ‘D’ or ‘F,’ often because they compile data only about primary care doctors, not specialists.

Photo by Phil Jern via Flickr

Washington state and Minnesota were the only states that got an A from the Health Care Incentives Improvement Institute, a nonprofit group that designs programs aiming at boosting health care quality and affordability.  California received a ‘C,’ and the rest of the states got either ‘D’s or ‘F’s. The report scored states on several factors, including the percentage of doctors they rated, whether those ratings included information about patient outcomes and consumer experiences and how easy it was to find them through an Internet search.

Using a Robert Wood Johnson Foundation directory of websites that evaluate health care quality, researchers examined whether the information was current, free to consumers, produced by independent third parties and included a range of physicians, including specialists. Programs that failed to meet any of those criteria were excluded, as were physician “report cards” produced by health insurance companies because “patients distrust quality information coming from their insurance providers,” the report said.

“I was shocked because I honestly thought the availability of information on the quality of physicians was far more prevalent … It’s a very mixed bag,” said Francois de Brantes, co-author of the report.

The information is becoming increasingly important as consumers face higher deductibles and out-of-pocket costs and “want a sense of whether or not that money is being spent on physicians that will deliver high quality care,” de Brantes said.

Many states had information about primary care doctors, but not specialists.

“That’s only 10 or 15 percent of the cost of care,” de Brantes said. “They now might want to focus on the rest. When patients go and have procedures done by cardiologists or orthopedists or oncologists, they deserve to know the quality of care they are going to get.”

10 Responses to “Report: Most States Do A Poor Job Informing Consumers About Physician Quality”

  1. sam says:

    The Republican motto for rating physician quality? “What you don’t know won’t hurt you”. Republicans think that an educated consumer is a dangerous consumer…at least they are for business profits. Why do you think most businesses support Republicans? Republicans are not consumer friendly…never have been…never will be. The Affordable Care Act tries to make healthcare more transparent. Republicans hate that! Republicans like consumers to be in the dark…like mushrooms.

  2. sherrill says:

    Ludicrous!!! I have no idea where this statement comes from. Accessible information on physician quality or the quality of health care has absolutely nothing to do with the politics of either party. If we are in the dark, it is only because we have no standard tool for evaluation of either. As for the transparency of the ACA….what???

  3. There is a political component. Doctors have resisted reporting because of legal malpractice liability. While the GOP has sought tort reform to counteract this, the Democrats are funded by the Plaintiff’s lawyers and have resisted such reform. Providers need incentives to report, such as ‘safe harbors’ from liability. That is the only way.

  4. Jan Root says:

    I think the comments are missing the boat. This is not about Democrats or Republican policies. This study is about the non-existent transparency of the American healthcare system and the harm this does to consumers/patients. Providers do need some protections, but the balance needs to shift from the black box that currently exists on quality to much greater transparency. This article Is a call to action: the States need to step up to the plate and pursue policies that make this information available to the public.

  5. Tom says:

    I’m not sure a political debate online makes the issue more or less relevant…. What I do know is that when patients become more involved and educated in their health care, either because of cost or requiring improved care, they will require improved information on quality measures/ratings regarding their providers (all their health care providers: physician, PA, NP, office staff). The question is how to educate patients on where to find the best, non-influenced physician quality ratings and what quality health care from a provider and/or office staff really looks like.

  6. Paul Terrill says:

    As a Family Physician involved in the reporting process in Minnesota, I have to laugh a little at our state’s “A” grade. A review of the performance data generally makes it clear that large organizations with lots of in house IT expertise score better. Much if that is not better care but better data reporting. I print out treatment plans for asthma patients who’ve not had any problems for years because that is what is being measured. I can’t point to a single element of care I provide that has improved with the “transparency,” but the hassle of reporting has increased our overhead cost. Not everything that can be measured is important; not everything that is important can be measured. If you pick your provider based on their clinic’s “Minnesota Community Measures” scores you can be sure your provider will click all the right boxes on their computer. If you are lucky, they might have time make eye contact. If they do, it wont’ be reported, because there’s no reportable measure for that, yet.

  7. Randy says:

    Paul,

    Just curious. Congress is getting ready to repeal the SGR. It appears that a growing bipartisan consensus wants future Medicare payments to doctors to be based on a “quality” metric. In the past, the more a doctor saw a patient, the more they got paid, regardless of any improvement in health. Very few doctors really cared if a patient got healthy because a healthy patient meant less office visits. In the past, a filled waiting room meant that a doctor will have a very good day at the cash register. Obamacare provisions seems to want to promote a quality metric and now Congress seems to also want the same. In the future, it appears that the “quacks” will be pushed out of the market, as it should be. Your thoughts?

  8. J Alan says:

    I like Paul’s response. GPs are the heart of all medicine and do not get the recognition (or financial rewards) they deserve. Go to a good GP/FP and you’ll likely be referred to a good specialist if needed. I wouldn’t trust the Government to rate my practitioner. As Paul stated, such ratings are basically up for sale.
    60% of the surgeries in this country do not improve the condition of the patient. A third of the diagnostics are miss-interpreted. Don’t even get me started on the prescription issue. Do your own research and talk to your doctor. A good doctor will not be intimidated by this. If they cop an attitude, find a different doctor.
    I think people have let the Government take over too much of their thinking process and collectively; Government is as dumb as a rock.

  9. patty says:

    Physician quality? What patient quality? When does a “solo doc” have time to concentrate on quality? Ask any doc with a solo practice and they will most likely all say the same thing. “We can’t do everything!” Only group practices can keep up with the pace. The days of Marcus Welby type medicine is over. There are way too many distractions for a solo doc. From paying the utility bills to maintaining a computer system to hiring and firing staff people to getting the parking lot plowed to getting the grass cut to repairing a leak in the roof, all that and see patients too? These days, if docs want to stay in the business with less distractions, they must consider group practices where many doctors are all under one roof. Hospitals are leading the way in this regard. They are forming accountable care organizations (ACO) and patient-centered medical homes (PCMH) at an ever increasing pace. In these organizations, docs practice medicine almost exclusively. They are distracted less by the mundane minutia of running an office. Hence, physician quality improved because they are much better focused on the practice of medicine. Docs in the organizations get an attractive salary, they work regularly scheduled hours, they get paid holidays and paid vacations, they get pension packages, they get medical and dental benefits for themselves and their family. Will they get outrageously wealthy? Not like they did in the past! Fact is, the focus is less on them and their wealth and more on the patient and their health. The good ACO’s and PCMH’s will thrive. The bad ones won’t. The time for focusing on patient health is long overdue. The time where the “Consumer is King” is gradually arriving.

  10. Quinn says:

    There’s way too many nuts in this fruitcake. So much misinformation packed in only nine posts. That must be a record. Nobody here has a clue about how physician quality is, or isn’t, measured. The consumer has always been at the bottom of the food chain when it comes to healthcare. No insurance company and no healthcare provider wants to be critiqued by the customer. That’s way too risky.

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