Managing Managed Care

Our inequitable, inefficient, oftentimes uncaring health care "system," revealed. -- Jeffrey G. Kaplan, M.D., M.S.

Med. Newsletter / eBook

Be informed on reform; Newsletter and, if requested, a relevant eBook: "Mgd Care 101 in 2016" (No obligation)

Subscribe to Managing Managed Care newsletter feed

SSL Certificate

Physician Characteristics Don't Predict Quality

This article is posted in: 

How You Choose Your Doctor? Not By Their Clinical Quality.

It is unfortunate that physicians' characteristics don't relate to the quality of their performance.  To make matters worse,  information on physicians' performance on measures of clinical quality is rarely available to patients, and even if it were,  there's little accounting for acuity differences--'apples are being compared to oranges.'  It's a shame, but all most patients have to go by is is the doc nice, where did they get their training, did they pass their Boards and were they sued much.  Here's research that speaks to this....

Methods  We calculated overall performance scores on 124 quality measures from RAND's Quality Assessment Tools for each of 10 408 Massachusetts physicians using claims generated by 1.13 million adult patients. The patients were continuously enrolled in 1 of 4 Massachusetts commercial health plans from 2004 to 2005. Physician characteristics were obtained from the Massachusetts Board of Registration in Medicine. Associations between physician characteristics and overall performance scores were assessed using multivariate linear regression.

Results  The mean overall performance score was 62.5% (5th to 95th percentile range, 48.2%-74.9%). Three physician characteristics were independently associated with significantly higher overall performance: female sex (1.6 percentage points higher than male sex; P < .001), board certification (3.3 percentage points higher than non-certified; P < .001), and graduation from a domestic medical school (1.0 percentage points higher than international; P < .001). There was no significant association between performance and malpractice claims (P = .26).

Conclusions  Few characteristics of individual physicians were associated with higher performance on measures of quality, and observed associations were small in magnitude. Publicly available characteristics of individual physicians are poor proxies for performance on clinical quality measures.

Reid RO, Friedberg MW, Adams JL, McGlynn EA, Mehrotra A. >Associations Between Physician Characteristics and Quality of Care." Arch Intern Med 2010;170 1442-1449