Disclosure of Physician Information, Essay Example

Abstract

Evaluation of physician performance is comparatively new, rapidly evolving and complex, the need for accuracy, oversight and transparency, in the process is imperative. It is worthwhile to note that, in the event that an insurer is the sponsor, the profit motive could influence physician evaluation and/or reporting. This is a highly probable conflict of interest and hence necessitates inquiry, disclosure as well as oversight by suitable authorities.

Introduction

Disclosure of Physician Information is normally done through the use of physician report cards. The reports cards provide the ratings of physician efficiency and quality. The disclosures come to the public domain via relevant sources such as physician networks, quality profiles of health plan institutions, report cards, as well as health plan distributors’ websites. The broad variation in the cost-efficiency and quality of care provided by health care professionals and providers is well-documented. Consequently, meaningful efforts to evaluate and publicly report physicians practice comparative quality are necessary to facilitate consumers in making informed choices regarding from whom and where to access medical care. Additionally, experience has demonstrated that evaluating and reporting physicians’ performance publicly, based on cost-efficiency and quality supports medical service providers’ initiatives in improving their performance (Consumer- Purchaser Disclosure Project, 2008).

Are the physician reports cards fair and balanced?

However, since evaluation of physician performance is comparatively new, rapidly evolving and complex, the need for accuracy, oversight and transparency, in the process is imperative. It is worthwhile to note that, in the event that an insurer is the sponsor, the profit motive could influence physician evaluation and/or reporting. This is a highly probable conflict of interest and hence necessitates inquiry, disclosure as well as oversight by suitable authorities. The process of deciding on significant healthcare matters, such as selecting a primary care specialist or physician, consumers are at liberty to obtain accurate and reliable information unclouded by prospective conflicts of interest. The integrity, verifiable and independent nature of the process of rating is paramount (Consumer- Purchaser Disclosure Project, 2008).

Cost-efficiency and quality of performance are two categories in the evaluation of physicians that may be incorporated in the rating. In the information provided to consumers as well as public reporting, measures of quality of performance and measures of cost-efficiency are computed independently and disclosed as such. Subsequently, the individual scores for cost efficiency and quality of performance are pooled for the total ranking. The percentage of each measure is then plainly disclosed. This means that, in the coming years, the physician privacy will increasingly become more complicated. In the general perspective, the report cards present fair and balanced information. On the other hand, a small fraction of consumers peruse the current report cards and may not utilize the information due to reasons such as low health literacy, lack of awareness, or even limited choices (Smith & Rosenbaum 2009).

Mere accessibility of public information regarding a physician’s education, certification as well as malpractice claims is sufficient for patients to establish whether a particular physician offers quality care services. Patients and consumers of health care services can easily access the necessary information through physician report cards, health plans and, physician networks. It has been established that public reporting of information regarding physician quality may present valuable assistance to the consumers of health care services seeking high-quality health care services.

In order to preserve the interests of patients as well as physicians, policy-makers have initiated efforts to regulate the rating process of physicians as well as the manner in which the information ought to be presented to the end-users. Simultaneously, there are initiatives in place to develop better processes for data collection and reporting in a manner that guarantees accuracy as well as fairness, while at the same time providing consumers with functional information to facilitate better informed health care decisions. The “Patient Charter for Physician Performance Measurement, Reporting and Tiering Programs,” is a suitable example of a consensus agreement whereby a voluntary set of values for such programs that was sanctioned by physician networks, consumers, labor groups, employers and, health plans (Smith & Rosenbaum 2009).

References

Smith L.C & Rosenbaum. S, (2009). Aligning Forces for Quality Improving Health & Health Care in Communities Across America; Fair Process in Physician Performance Rating Systems: Overview and Analysis of Colorado’s Physician Designation Disclosure Act. Retrieved July 08, 2011 from http://www.rwjf.org/files/research/legalbarriersfairprocess.pdf

Consumer- Purchaser Disclosure Project, (2008). Improving Health Care Quality through Public Reporting of Performance Patient Charter for Physician Performance Measurement, Reporting and Tiering Programs: Ensuring Transparency, Fairness and Independent Review. Retrieved July 08, 2011 from http://healthcaredisclosure.org/docs/files/PatientCharter.pdf