Conventional wisdom says “ask around.” Conventional wisdom is wrong.
A good doctor has a good track record.
The search for a new doctor usually begins with friends and family. While friends and family often have strong opinions about doctors, those opinions are rarely based on evidence. Instead of “asking around,” a smarter strategy is to follow the data.
Some data can be gleaned from online physician-rating sites, such as Healthgrades and Vitals. They are ready sources of basic information, including types of insurance accepted, hospital affiliation, languages spoken, and years in practice. Similar information can also be obtained through your medical insurer’s website. While insurance company websites tend to be less user-friendly — typically requiring registration and confirmation of membership — their information will be directly pertinent to your coverage.
Physician-rating sites are best known for their one-star to five-star reviews. Despite the quasi-scientific nature of these ratings, their validity has been questioned. A health policy review found that they prioritize immediate gratification over long-term benefits. And, a study of more than 50,000 patients showed that higher levels of patient satisfaction on these reviews were associated with more frequent hospitalizations, higher healthcare costs, and an increased risk of death.
The “Top Doctors” lists that regularly appear in local magazines are a popular source of information. While these lists generate a lot of attention and serve as a badge of honor for doctors and their institutions, their results may be biased. Concerns about bias include vote trading among doctors (i.e., I’ll vote for you, if you vote for me) and lobbying on the part of large medical centers. Some for-profit companies have even been reported to offer “top doctor” awards in return for a fee.
Fortunately, there are steps each of us can take to make informed decisions about doctors. The first is to ensure that your doctor is board-certified. Board certification ensures that a doctor has met professional standards for knowledge and competency and that he or she has stayed current with evolving standards of practice. Data on the board certification of individual physicians is freely available from the American Board of Medical Specialties.
The next step is to ensure that your doctor holds an unrestricted medical license that is free from disciplinary actions. In 2017, more than 4,000 physicians were disciplined for substandard care, substance abuse, sexual impropriety, or a number of other misdeeds. This information is freely available through the Federation of State Medical Boards.
Data on how well Medicare physicians perform on quality measures — such as vaccination rates against shingles and compliance with screening recommendations for colorectal cancer — may be found on Medicare’s Physician Compare website.12 One weakness of this site, however, is that data may be incomplete and may not be available for all physicians.
Private insurers are also beginning to give consumers tools to compare physicians. Anthem’s Care & Cost Finder, UnitedHealthcare’s Peer Comparison Reports, and Cigna’s Care Designation allow their members to compare physician performance on quality, cost- efficiency, and adherence to standards of evidence based medicine.
Searching multiple websites for these data can be a tedious and frustrating process, but one should view it as due diligence: a labor-intensive but essential step in any major decision. A physician who is board-certified, who performs well on cost and quality measures, and is in good standing with his or her state medical board, is likely to be a good doctor.
Weighing the results of this process against the recommendations of friends and family can reveal important information and, occasionally, unpleasant, surprises. But being forewarned by data is better than being surprised by “asking around.”
