The ratings cycle
July 27, 2013
The Boston Globe recently ran an article about hospital ratings. The article presents several interesting points, including the statistic that 9 out of 10 hospitals are rated as "average" in terms of mortality rates. What's particularly interesting is how people from the provider community feel that a rating system may make inappropriate distinctions and that "a worthwhile hospital ranking system would need to be based on more sophisticated underlying data than what's now available." A similar phenomenon happens with the idea of rating doctors:
1) Consumers want to figure out which doctors to select for their personal care
2) Organizations create some ranking system based on insufficient data
3) Providers complain that the ranking system is clearly flawed, citing a lack of meaningful data
4) People call for the release of the data that would be meaningful
5) Providers respond with silence
In step 5, you might get what seems to be a more reassuring response like "any accredited doctor/hospital is qualified to treat patients," but that dismisses the fact that there is tremendous variation even among accredited providers. Just because a group of investors might all have the same appropriate credentials doesn't mean that there is uniformity with their returns. You can probably say the same for any profession that requires thought and skill, so why not medicine? Just because a provider is qualified to treat a patient doesn't mean that provider will be the best choice for that patient. And when the patient has something significant on the line (such as quality of life), it's understandable that the patient wants to select the best choice, not just any qualified provider.
So, rather than see people from the provider community hide behind the "lack of meaningful data" excuse, how about they actually change the cycle by releasing the data that they want to be rated on? By only complaining about the ranking system and not trying to shape it, providers give up an important opportunity to shape a dialogue that is already happening.