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Does physician report card trend fail patients?

Physician Practice Advisor, March 16, 2005

When students load their schedules with easy courses just to improve their grade point averages, they only end up hurting themselves. But when the incentive to get good grades is applied to healthcare, some observers believe it's clearly the patients who suffer.

A critique by two physicians, which ran in the March 9 Journal of the
American Medical Association, cited studies that conclude that some doctors play pick-and-choose with their patients, purely to maintain high scores on the "physician report cards" being implemented by hospital systems throughout the country.

According to the Associated Press, article authors Rachel Werner,
M.D., and David Asch, M.D., made specific reference to a 1997 survey of 104 New York heart surgeons, in which two-thirds said that they selected healthier patients for surgery and rejected sicker ones following the initiation of a state policy requiring the reporting of patient death rates. The result of that study and others suggests that the report card system may not offer truly representative measurements of doctors' skills and abilities.

"I don't want to come across as being against quality improvement," Werner told the AP, "but we need more empirical evidence before we launch the universal projects that people are talking about."

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