When I entered residency many years ago, a local physician sparked a fierce controversy when he ran a display ad in the Yellow Pages. Now, physicians use billboards to promote the augmentation of body parts that were once unmentionable in polite company. So I guess it was just a matter of time until consumers began rating physicians—along with plumbers, painters, movers, and more—on Angie’s List.
I don’t deny that consumer views of health care are important. But isn’t there a more robust, valid, and transparent way to collect important information about physician performance? I hope to find out over the next couple of years.
Cincinnati, where I live and practice, is one of 14 communities participating in the Robert Wood Johnson Aligning Forces for Quality initiative. One of our key projects is to develop a community-wide means of publicly reporting quality measures, based on primary (not claims) data. We’re starting with diabetes and cardiovascular care, but will add a host of other measures if we succeed.
Why go to the trouble?
I think physicians need to take the lead in accountability and public reporting—not the Centers for Medicare & Medicaid Services or local insurers, and certainly not Angie’s List. We need to promulgate public reporting principles, ensuring that the information is:
- verifiable, valid, and standardized
- focused on patient-oriented outcomes that matter
- tied to performance improvement
- understandable and able to influence clinician and patient behavior.
I also believe in a little frank and friendly competition. Standardized reporting allows head-to-head comparisons with our peers, and keeps us striving for improvement. What’s more, it arms patients with the information they need to make sound health care decisions. Sure, the public’s experiences—with friendly clinicians, pleasant receptionists, timely appointments, and even the magazines in the waiting room—matter. But our patients deserve more.
Achieving the reporting standards we’re striving for won’t be easy. But isn’t it better to face this challenge ourselves than to be lumped in with dog groomers, mechanics, and chimney sweeps?