HealthContentAdvisors

Physician Transparency: Why the Angst?

• Posted April 24th 2008
• by Russell

Last summer, a non-profit consumer advocacy group called Consumer’s Checkbook won a landmark victory in court: a U.S. federal court ordered the Department of Health and Human Services (HHS) to provide detailed Medicare claims data to the group. While containing no information that could identify individual patients, the data would allow a look at what types of procedures were being performed by individual physicians, and how often. In short, the data would provide an objective indicator of physician expertise. The reason Consumer’s Checkbook had to go to court for the information was that HHS had taken the stance that it couldn’t release this information because it would constitute an invasion of physicians’ privacy because it would indirectly allow anyone to calculate how much money a physician received from the government. The court shot down this argument and ordered release of the data.

One would expect that with HHS advocating at the highest levels for transparency in healthcare, and with a number of its own quality assessment and measurement initiatives, HHS might embrace this court ruling and get moving on this release of data. Instead, in a quiet court filing last week, HHS appealed this court decision. While HHS has publicly stated it is only seeking help from the court to reconcile several conflicting court decisions, published reports indicate its appeal filing with the court seeks to reverse the previous court decision, leaving restriction on disclosure of this information in place. Robert Krughoff, president of Consumer’s Checkbook, attributes this odd move by the government to pressure from the American Medical Association, stating “We regret that the AMA has pushed HHS so hard to hide this information.

Less than a month ago, the consumer ratings service Angie’s List announced that it would allow its consumer members to start rating physicians on everything from the cleanliness of waiting rooms to a physician’s bedside manner. The announcement immediately drew response from the physician community, including a fairly representative comment from Dr. Jon Marhenke, president of the Indiana State Medical Association, who said “doctors’ services to patients can’t be compared to the work of a skilled tradesman.”

All this points up an essential conundrum: physicians to a large extent seem to be resisting rating, evaluation and review at the exact same time that the move to consumer-driven healthcare is making this kind of information important if not essential. And this is not a new problem. For too long, patients have been selecting their physicians based on an awkward combination of word of mouth referrals, health plan participation and geographic proximity. That’s not good for patients, but what physicians apparently don’t see is that it’s not good for them either. By rejecting third party evaluation and review, physicians aren’t elevating themselves above the fray. Indeed, they are commoditizing themselves. By refusing to provide useful differentiation about their training, expertise, and yes, even their beside manner and office tidiness, physicians are telling patients “we’re pretty much interchangeable,” and leaving patient to select physicians based on criteria and information that can be highly subjective, biased, irrelevant and even inaccurate. There is a huge need for information to help differentiate physicians and this vacuum will be filled. And as every good marketer knows, if you don’t write your own story, others will write it for you, and you probably won’t like the results.

Physicians: market thyselves!