The President’s Podium: In the Court of Public Opinion

by Ronald Dunlap, M.D., President, Massachusetts Medical Society

With the constant push for quality, safety, and transparency, the practice of  rating physician performance is becoming as commonplace as the stethoscope in health care.

Insurers have developed tiers; the federal and state governments and private organizations have launched websites. Local and national magazines rate physicians individually and by group practices. Patients can rate their doctors on any number of websites. The focus on ratings has become so widespread that even organizations best known for reviewing restaurants and home services have joined the club.

Some physicians bristle at the notion of such assessments. A few have filed lawsuits in response to negative reviews, and some, in attempting a preventive strategy, have asked patients to sign documents promising not to use any rating websites. This tactic has backfired and not surprisingly, strained the physician-patient relationship.

Like them or not, ratings are here to stay. Some provide useful information; some not so much, merely allowing disaffected patients to vent about the care they think they should have received, how much time they spent in the waiting room, or why they couldn’t talk to the doctor when they wanted. The methodology used by some organizations and the low sample size may also raise questions. Fortunately, most experts will caution patients about such information, advising them to judge the relevance, accuracy, and reliability of the information with extreme care and to use the information as just one of many factors when judging physicians.

To be sure, physician performance is a critically important and complex issue, and MMS has been ahead of the curve. Back in 1999, MMS first developed our Principles for Profiling Physician Performance, which has since been updated. That was followed by a similar document for health plans, and we’ve even provided guidance for patients.

In the end, each patient individually will determine how well his or her doctor is providing care, and that perhaps is the only rating that truly matters. But reasonable patient input and well-constructed surveys can offer a yardstick for measurement, especially with so many changes taking place in health care.

With that in mind, here’s a look at some responses from the MMS’s recent public opinion poll that relate to physician performance:

  • 84% expressed satisfaction with the care they received over the last year. Notably, that’s comparable to the 88% rate of satisfaction in 2004, when we first asked the question. 51% cited quality of care as the biggest reason for their satisfaction.
  • 74% said they have asked their physician for suggestions when deciding where to go for medical care, signaling that the physician remains the most preferred source of information about care.
  • 67% said they would prefer to receive care from a physician; this despite the proliferation of retail clinics and a new state law allowing nurse practitioners and physician assistants to act as primary care providers.

There’s always room for improvement, and while one hundred percent in every category will remain the target, the judgment from our patients again this year is that Massachusetts physicians and health care providers are living up to their reputation for quality care. That’s good news for physicians, and the high level of satisfaction over a decade, in which huge changes have occurred, is especially gratifying. But let’s remember this: the court of public opinion on health care is always in session. And that’s just as it should be.

The President’s Podium is a new feature that appears regularly on the MMS Blog, offering Dr. Dunlap’s commentary on a range of issues in health and medicine.   



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