Richard makes a good point: why would we rely on the opinions of other patients when we pick a physician? We care most about how much an MD knows and how well they perform – after all, we want to be kept alive and healthy. Most of us would trade the warm smile and prompt visit may impress others, for extra years of healthy, active life.
It is not hard to imagine an excellent system to rate how good a physician really is. You want to test his or her knowledge of the illnesses and treatments that might affect you. You want to know how well he performs against other physicians in treating real-life patients, those with diabetes, heart disease, and ear infections. You want to know how thoroughly she informs her patients of what they really need to know, and whether she delivers the preventive care that you need to stay healthy. And you’d really like to know if his patients are healthier and live longer than those of other physicians.
Unfortunately, that information isn’t available. What is available isn’t even close to that ideal. Mostly people rely on what their friends, family, or other physicians recommend, and there’s no evidence that is any better than flipping a coin when trying to identify a better-than-average physician. What else can you do?
The answer is that patient opinions, for all their shortcomings and obvious problems, are one of the best answers we have today. One example supporting this is the Consumer Assessment of Healthcare Providers and Systems, a system of scoring physicians and hospitals through patient surveys, which is being used by the US Department of Health and Human Services to improve performance. Another example is California’s Integrated Healthcare Association, which rewards medical groups in part on the basis of patient assessment of physician performance. No, it’s not ideal, but it’s a start.
Don’t make the perfect the enemy of the good. Until we have real comparative information on physician performance and outcomes, consumer satisfaction is probably the best we can do to identify the physicians that most deserve our patronage.
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