One way to keep government out of the business of regulating medical care is for leading health associations to step up to the responsibility of policing their own.
But such efforts are bound to fail when they are transparent attempts to polish the industry's public image.
The American Medical Association's effort to give outstanding physicians a seal of approval looked to be a positive development when it was announced last summer with great fanfare. Now the American Medical Accreditation Program, set to get under way this summer in Alabama, Massachusetts and New Jersey, appears to be letting physician self-interest crowd out the program's potential public benefit.
Initial AMAP standards announced last month fail to address the need for physician data to help the public make informed medical decisions. Unlike some other existing performance measures, the AMAP will not provide information on how individual physicians score on accreditation standards. No patient satisfaction scores, no information on doctors' strengths and weaknesses, no way to compare individual doctor performance in clinical areas.
Such comparisons are doable. New York and Pennsylvania provide public reports on cardiac-surgery outcomes on a physician-by-physician basis. Meanwhile, the Joint Commission on Accreditation of Healthcare Organizations, through its Oryx program, is making performance measurement a part of the accreditation process for hospitals and systems. On the health plan side, the National Committee for Quality Assurance and the Foundation for Accountability are working to present outcomes data in a form the public can use and understand.
The AMA says it has plans to incorporate patient-satisfaction and other quality data, but its opposition to opening National Practitioner Data Bank records to the public doesn't bode well for disclosure of physician-specific information. The AMA would do well to keep in mind the incontrovertible trend toward more accountability in healthcare.