The Agency for Healthcare Research and Quality (AHRQ) is the lead federal agency charged with sponsoring and conducting research on the quality and outcomes of health care services. It offers this cautionary advice on choosing a doctor:
"It is important to choose your doctor with care…Health care quality varies in this country—a lot. [S]ome health plans and doctors do a better job than others of helping you stay healthy and getting you better if you are ill." (1)
Patients looking for a doctor are advised to compile a list of alternatives and then “check on their skills and knowledge and the quality of care they provide.” (2)
That, however, is easier said than done for a number of reasons:
- Information on physicians’ performance on measures of clinical quality is rarely available to patients. Instead, patients are encouraged to select physicians on the basis of characteristics such as education, board certification and malpractice litigation history. But those publicly available factors have been shown to be poor proxies for performance on clinical quality measures.(3)
- Online sites that present patient reviews have no reviews for most physicians. Even when there are reviews on a physician, the number of reviews is too small to provide a meaningful evaluation of the physician. Furthermore, it is not uncommon to find very favorable reviews that appear to have been written by the physicians themselves.(4)
- Aprimary care or other physician may refer a patient to another physician for reasons other than clinical expertise, including reciprocity (patients are referred in both directions), personal relationships, insurer pressure to refer within a network and financial incentive to refer to a physician-owned facility. (5)
1. Agency for Healthcare Research and Quality (AHRQ). Your Guide to Choosing Quality Health Care. July, 2001.
2. Agency for Healthcare Research and Quality (AHRQ). Your Guide to Choosing Quality Health Care. July, 2001.
3. Reid RO et al. Associations Between Physician Characteristics and Quality of Care. Arch Intern Med. 2010; 170:1442.
4. Lagu T et al. Patients’ Evaluations of Health Care Providers in the Era of Social Networking: An Analysis of Physician-Rating Websites. J Gen Intern Med. 2010; 25:942.
5. Kirsch M. How doctors choose which specialists they refer to. Medpage Today. May, 2010