0
We're unable to sign you in at this time. Please try again in a few minutes.
Retry
We were able to sign you in, but your subscription(s) could not be found. Please try again in a few minutes.
Retry
There may be a problem with your account. Please contact the AMA Service Center to resolve this issue.
Contact the AMA Service Center:
Telephone: 1 (800) 262-2350 or 1 (312) 670-7827  *   Email: subscriptions@jamanetwork.com
Error Message ......
JAMA Patient Page |

How to Use Online Clinician Rating Systems FREE

Aria A. Razmaria, MD, MSc; Edward H. Livingston, MD
JAMA. 2015;314(13):1418. doi:10.1001/jama.2015.11957.
Text Size: A A A
Published online

Every patient has a right to know about his or her clinician’s expertise and outcomes.

WHAT ARE PHYSICIAN RATING SYSTEMS?

Online scoring systems are available that attempt to rate clinicians’ expertise and outcomes. These include Medicare’s Physician Compare (www.medicare.gov/physiciancompare/search.html), Consumers’ Checkbook’s Surgeon Ratings (www.checkbook.org/surgeonratings), and Propublica’s Surgeon Scorecard (projects.propublica.org/surgeons). Physician Compare has basic information about a physician’s qualifications and some clinical outcomes information (like how many patients in a clinician’s practice have good diabetes control). Consumers’ Checkbook and ProPublica attempt to display how often patients have complications after their operations. These systems try to identify clinicians who have acceptable results or rank them as being better or worse than average, but in the current format, these rating systems have significant limitations that make them of uncertain value for patients.

RELIABILITY OF THE RATINGS

Physician Compare provides information about clinicians who provide care for Medicare patients (which is most US physicians). Most of this is objective information and provided by clinicians themselves, so it is generally accurate. The other rating systems that attempt to provide individual clinician complication rates have issues limiting the utility of the rating systems. First, there are typically delays of greater than 1 to 2 years in the clinical outcomes data appearing in the scoring system. Second, not all of the metrics used to assess clinicians are universally accepted as valid measures of a clinician’s outcomes. Both the Consumers’ Checkbook and ProPublica scoring systems rely on data collected from the system doctors and hospitals use for billing Medicare. Because the data are intended for billing and not measuring clinical outcomes, important information about a patient’s clinical condition may be missing, important complications may not be identified, and the data generally pertain only to patients older than 65 years. Third, Consumers’ Checkbook and ProPublica are private agencies and have no public accountability if they make mistakes. They are not required to validate their metrics prior to publication. Fourth, some of the reported complications may not be caused by the clinicians in the database. The complications may be caused by other clinicians or problems with the hospital itself but are assigned to the clinicians because of incomplete or inaccurate information. Fifth, the rating systems are not fully risk adjusted (a risk-adjusted score accounts for a clinician’s taking on high-risk patients, problems, or surgeries). Clinicians who take care of sicker patients will have more complications, so risk adjustment attempts to level the playing field. Unfortunately, because of limitations in the data source used for these scoring systems, the risk-adjustment calculations cannot completely account for all the risks involved in delivering clinical care.

HOW TO USE THIS INFORMATION

The available physician scoring tools may not yet be reliable enough to be used as a basis for decision making when selecting a clinician. The information they contain is incomplete and likely sometimes inaccurate. The ratings can serve as the basis to initiate a conversation with a clinician. One approach to selecting a clinician is to ask other clinicians (such as your primary care clinician) what their experiences have been with that clinician and with patients the clinician took care of. When seeing the clinician you are considering getting treatment from, feel free to ask questions such as: How necessary is the treatment that is recommended for me? What are the alternatives to the proposed treatment? What are the clinician’s and hospital’s experience and expertise in providing the proposed treatment? How often do they perform the treatment? How are complications monitored, and what is done to ensure the best result possible? How will I be cared for after I get the treatment?

Box Section Ref ID

For More Information

To find this and previous JAMA Patient Pages, go to the Patient Page link on JAMA’s website at www.jama.com. Spanish translations are available in the supplemental content tab. A Patient Page on what to ask your surgeon before an operation was published in the February 3, 2015, issue of JAMA and provides more detailed questions to ask before considering having surgery.

ARTICLE INFORMATION

The JAMA Patient Page is a public service of JAMA. The information and recommendations appearing on this page are appropriate in most instances, but they are not a substitute for medical diagnosis. For specific information concerning your personal medical condition, JAMA suggests that you consult your physician. This page may be photocopied noncommercially by physicians and other health care professionals to share with patients. To purchase bulk reprints, call 312/464-0776.

Sources: Centers for Medicare & Medicaid Services

Wei S, Pierce O, Allen M. Surgeon Scorecard. New York, NY: ProPublica; July 14, 2015.

Topic: Patient Safety

Tables

References

CME
Also Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
Please click the checkbox indicating that you have read the full article in order to submit your answers.
Your answers have been saved for later.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.

Multimedia

Spanish Patient Page: Cómo usar sistemas de calificación en línea de los médicos

Supplemental Content

Some tools below are only available to our subscribers or users with an online account.

5,205 Views
0 Citations
×

Related Content

Customize your page view by dragging & repositioning the boxes below.

Related Collections
PubMed Articles
Jobs