Taking exception to faulty computerized physician rating systems:
After 26 years of a successful medical practice, Alan Berkenwald took for granted that he had a good reputation. But last month he was told he didn’t measure up — by a new computerized rating system.A patient said an insurance company had added $10 to the cost of seeing Berkenwald instead of other physicians in his western Massachusetts town because the system had demoted him to its Tier 2 for quality.
“Who did you kill?” the man asked sardonically, Berkenwald recalled.
(via The WSJ Health Blog)
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- Beware the dangers of universal health care
- UnitedHealth’s physician ratings: "Dishonest"
- Do physician quality measures tell patients who’s a good doctor?
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{ 3 comments }
I think the solution to the problem is quite clear. Physicians absolutely can not take this type of abuse, and we must all take every effort in our power to no longer contract with insurers who play this way, even if it means loss of income. The future is clear. Playing their game will result in overwhelmingly negative outcomes for physicians. The only winners will be the insurers.
The industry’s response to the demonstration that the data is flawed, inconsistent and inaccurate is simple–”tough tittie”. It’s like days of Lenin and Stalin–the individual has no right to justice and only the collective imperative to reduce overall costs (and make a billion dollar salary for the CEO) overrides petty personal injustices.
Independent urologist is right. Doc should simply refuse to play. Don’t sign participation agreements. Then sue for defamation of character if they try to do this anyway. Docs can do a lot when they stand up on their own hind legs.
Until fairly recently, physicians have been beholden to no one. They were free to do what they wanted with patients, and weren’t held responsible for poor care; most importantly, patients have had virtually no access to accurate information about the quality of care provided by different physicians.
So before physicians throw up their arms and cry “abuse!”, perhaps they should propose a solution to the huge variations in quality of care.
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