Patient Power

What happens when consumers are able to compare the performance of primary care physicians in their state using Consumer Reports, the magazine that’s so highly regarded for its ratings of thousands of products and services we all use every day? Well, for the first time ever, we’re about to find out.

A special Massachusetts version of July’s Consumer Reports magazine will feature a report entitled “How Does Your Doctor Compare?” along with a 24-page insert that includes ratings of nearly 500 primary care physician practices from across the state. The ratings are based on data from a comprehensive patient experience survey conducted by Massachusetts Health Quality Partners (MHQP), a coalition of consumers, physicians, hospitals, insurers, employers, government agencies, and researchers. The physician ratings report is also available online at www.mhqp.org.

In recent years, there’s been a lot of talk in the health care community about the importance of consumer empowerment and patient-centered care. This experimental collaboration between MHQP and Consumer Reports, funded by the Robert Wood Johnson Foundation’s Aligning Forces for Quality program, helps move theory into practice, and will test some key assumptions about the value of transparency in the effort to improve the health care system. In many respects, ratings of primary care physicians are not new to Massachusetts. We at MHQP have been reporting the results of patient surveys and clinical quality data since 2006 and these reports have had a positive effect on health care in our state. But let’s face it, Consumer Reports adds a whole new dimension to the notion of transparency. Not surprisingly, their involvement has been met with both excitement and some trepidation in the physician community.

The latest MHQP performance ratings are based on 65,000 responses to a 2011 survey that asked patients and parents of pediatric patients about multiple, specific aspects of the care they received from their primary care doctor and their doctor’s office. Unlike ratings based primarily on patient satisfaction, we use nationally accepted and extensively validated measures of both the quality of clinical interactions experienced by patients and the way offices function on their behalf. For example, patients told us:

·Whether their doctors listen to their needs and concerns

·Whether their doctors spend enough time with them

·Whether they understand how to take care of their problems after leaving the doctor’s office

·Whether it is easy or hard to get appointments or have their questions answered over the phone

·How hard or easy it is to get lab or other test results

·How well their doctor coordinates their care with specialists

Published  in collaboration with Consumer Reports, the magazine’s Massachusetts insert includes regional listings of Massachusetts primary care practices with summary ratings for five key patient experience measures and a patients’ “willingness to recommend” score. In addition, 20 questions from the MHQP survey are discussed in detail, with tips for patients on what they can do to have a better care experience.

From MHQP’s perspective, the overarching goal of gathering and reporting this kind of data is to provide both patients and doctors with information they can use to improve the quality and outcomes of care. Based on our experience so far, significant progress is being made on the physician side of the equation. We’ve found that many doctors and their care teams use our reports to compare their performance to others and identify areas for improvement. In fact, since our last survey in 2009, Massachusetts patients have reported significant improvements in multiple aspects of the primary care experience. For adult primary care physicians, the greatest improvements were made in how well doctors coordinated care, including how well doctors followed up with patients to give test results and how informed and up-to-date doctors were on the care their patients received from specialists. For pediatric primary care, the greatest improvement was in how well physicians knew their patients, including their medical history. These new results highlight the real and important progress that practices of all types and sizes are making in every part of the state, as well as opportunities for continued improvement.

We’re hoping that our collaboration with Consumer Reports will shed new light on how to make this information more accessible and useful for patients as well – beyond displaying it on our website as we have for many years. Ideally, consumers should use patient experience data to better understand what they can and should expect from their primary care doctors and what they can do as patients to make informed choices about their own care and build a stronger relationship with their doctors. In turn, patients with better care experiences are more likely to use health care services wisely, and more likely to follow through with medical advice and treatment plans from their doctor’s office.

Ultimately, we hope and believe that the reliability of the data, the credibility of the two organizations responsible for the research and reporting, and a process based on collaboration and the desire for continuous improvement, will combine to gain the confidence of consumers and physicians alike and help advance the cause of patient-centered care, in Massachusetts and elsewhere.

Barbra Rabson is executive director of Massachusetts Health Quality Partners. The collaboration between MHQP and Consumer Reports is part of a pilot project aimed at developing better methods for providing consumers with valid, reliable, and useful health information funded by the Robert Wood Johnson Foundation’s Aligning Forces for Quality program.

8 replies »

  1. I always referred to the rights of patients. However, in a sense the patient in the hands of healthcare workers. I think it is a useful publication rights or the rights of health professionals to define the eyes of Clavis panax polite Mustafa Eraslan

  2. Jim-
    The research you cited has to do with patient satisfaction. The MHQP/Consumer Reports survey is based on patient experience. These are two different things. For example, one survey question asked was whether or not the doctor asked the patient if they experienced “a period of two weeks or more when they felt sad, empty or depressed.” This is not a question of patient satisfaction, but rather experience…either the doctor asked the question or didn’t. In this case, 61% of the respondents reported that they were not asked this question. By asking this question, and identifying patients who are expriencing depression early in the episode, substantial savings may be realized by avoiding potential hospitalization and other health care problems associated with depression such as heart disease. Not to mention relieving the suffering that depression causes.

  3. Rule of thumb, people are more prone to comment when negative than positive.

    Think about it, when was the last time anyone who wanders amongst these threads just spontaneously thanked a colleague or ancillary person in an office or halls of the hospital for helping out, doing a good job, hell, just doing their job and not asking for accolades?

    Everywhere I have worked in community health care, there are lots of negative commentary, and I feel much of it these days just echoes the entitlement and dependency that the indigent have come to expect, but, there are positive ones as well. So what do you gain from this as an admin person?

    How about pick up a chart and read it and gleen what you can? And pay attention to the basic feel of the office environs when there is no active crisis or mayhem at hand!

  4. Really nice to have information like this.You know this scenario is just reverse in South Asian countries like Bangladesh.Here doctor is the most powerful they are just hopeless and helpless.However, people are trying to make them attractive by Plastic surgery in plastic Surgery Hospitals.www.joshbd.com

  5. Physician commenter on Sermo who was rated by CR noted that his partner, who shares the same waiting room, was rated poorly on the waiting room being clean whereas he was rated good on the same measure. How can that not call into question the validity of all the other scores?

  6. If you’re not including contracted fee schedules (which can vary by as much as 300%), you’re comparing Volkswagons and Cadillacs. But if you want to make it tougher on the docs in the trenches doing the low-paid work, great job!

  7. I think this is an excellent idea and should be replicated in other areas of the country and expanded to include nurse practitioners, physician assistants and specialty physicians. As a nurse practitioner in the emergency department, I see a lot of non-emergent patients. In fact, I see mostly non-emergent patients. Many of my visits with patients begin with statements like “I know, this is not an emergency, but I called my PCP and their next appointment is not for three weeks”. Or, “I just don’t like my primary care provider so I came here instead”. Other patients simply do not have a primary care provider and do not know how to go about finding one. The public needs a way to find quality healthcare providers.