Not always.
Most quality measures are based on billable data, such as rate of breast or colon cancer screening, or in young women, the rates of chlamydia screening.
But do these numbers necessarily tell patients who are the best doctors?
Over at Better Health, Evan Falchuk has his doubts. He asserts that “the information is simply not valuable to consumers. Worse, I think it is deeply misleading. A medical group that does chlamydia screenings on 100% of its patients may be good or bad – or it just may be smart enough to know that if they do the state of Massachusetts will rate them with five gold stars. But consumers won’t be able to tell the difference.”
Again, doctors will respond to the incentives. If quality measures are used to tell the public which doctors are “good” or “bad,” you can bet that practices will do all they can to bring their numbers up, despite many of the measures’ flaws.
And there is no quality measure for time spent with patients, which perhaps is the most important trait patients look for in their physicians.
Related posts:
- How following hospital quality measures can kill patients
- Adopting hospital quality measures too quickly can harm patients
- Quality measures
- Quality measures . . that can kill
- Are quality measures doing more harm than good?
- Comparing hospital quality and cost in Massachusetts
- Why today’s quality measures do not improve health outcomes
{ 4 comments }
I personally try to get references from friends ( I have a lot of doctor friends) when possible. I used Yelp once to find a dentist and that worked out well. The biggest problem that I see with social media reviews is that you must look at the reviewer and scrutinize their qualifications. App reviews are one of the worst. People review more on what the app does not do instead of what it does and do not take pricing into account for the features provided.
I see doctor getting unfair ratings downgrades for not spending enough time with a patient. Doctors basically work by the hour, if they have an extended visit they must charge additional time. People except this if the worker is a plumber but not a doctor.
I think that the rating system must be from some sort of standardized metrics.
Jeff Brandt motionPHR Personal Heath Record for the iPhone
MyMedBox – PHR lite for Android
Patient outcomes can not be used to determine whether a doctor is good or bad. Each case is too individual to label. What about the Dr’s who specialize in treating very complex cases, will they be downgraded because they are willing to accept and treat tough cases? What measures are used to determine that this is a good outcome? What if the outcome is as good as possible but the patient still isn’t satisfied or didn’t like the Dr? How much is this data crunching going to cost and who will pay for it? Will patients be educated enough to read all that goes into this data adn read between the lines?
I believe that consumer rating sites of docs will have minimal impact on practices. The rewards for better practice come from efforts such as pay-for-performance, use of eprescribe, etc. These sources of revenue will drive physician behavior. Don’t believe me? Look how payers–Medicare, insurers, etc.–have affected the supply of primary care docs. So, as far as measuring care, I believe that population level data, such as the average of the A1c level of diabetic patients in a practice, will affect physician behavior more than consumer rating sites. In the near future, I believe that the greatest impact on physician behavior will be the new programs offered by the present administration and Congress’s in the Healthcare overhaul. I certainly hope that physicians and patients have a positive outcome from these programs.
The problem with the plans for health care reform is that they are almost entirely focused on how health care is financed, not on how to help physicians and patients work better together. The administrative burdens alone of the new IT mandates will add new work to already over-stretched doctors offices. And we can also expect that reimbursements to doctors will continue to come under pressure, furthering existing problems with doctors having to see too many patients.
Doctors being paid to spend more time with their patients would probably do more to improve health care quality than any set of complicated performance metrics we can come up with.
Evan Falchuk
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