Friday, February 6, 2009

Data About Doctors: A New Court Ruling Creates Controversy

Much like the children of Lake Wobegon, all doctors, to their patients, are above average. It is time to give you another secret of medicine: Some doctors did graduate at the bottom of their class and some doctors are not as good as others. How do you know if seeing your doctor will result in quality care? It isn't easy.
Depending on your point of view, a new decision by the Federal Appelate Court either makes the already difficult job of compiling, analyzing and reporting on physician specific data even harder or prevents misleading data from being reported. The decision is that the US Department of Health and Human Services is not required to release data on 40 million patient cases involving 700,000 physicians under the freedom of information act.
The data is physician specific Medicare claims data which is billing data, not medical records. Thus physician groups are worried that it can be interpreted in misleading ways and may breach confidentiality. Payers are arguing that while imperfect, the data still will move us forward in understanding individual physician practice patterns and allow for better decision making.
I know that both sides are partially right and that the issue will not go away.
This is just one scene in a multi-act play and we have not even reached intermission. I am sure that we will continue to move forward with increasing information available on individual physicians. The challenge will be determining the right measurements for physician quality and gathering the information in a way that maintains the integrity of the data while always maintaining doctor-patient confidentiality. There are no easy answers.