Former New York Mayor Ed Koch got a lot of political mileage by greeting his constituents with a rather corny "How'm I doing?" as he went about his city.
Koch had the right idea. Today's medical groups need to take the initiative in giving consumers better information on medical costs and quality. Those who figure there's plenty of time to act surely recognize that activist consumers haven't been shy about demanding information regarding consumer goods and services of all kinds. Now they are waking up to the fact that they are entitled to know more about the people they entrust to take care of their bodies.
Not surprisingly, the West Coast leads the country in measuring performance, but watershed events are unfolding elsewhere. In Wisconsin, consumer demand drove the Legislature to pass a law requiring physicians to turn over medical-quality and financial data to a government agency--something it and 37 other states already require hospitals to do. Indiana lawmakers are considering similar physician legislation.
Some medical groups aren't waiting to be asked. Brown & Toland Medical Group, one of California's largest independent practice associations, released its own statistics on preventive care and patient satisfaction just days before managed-care giant PacifiCare Health Systems issued a public report rating the performance of almost 120 of its contracted medical groups and IPAs on everything from medical screenings to members' complaints.
Meanwhile, the Pacific Business Group on Health has issued public report cards on dozens of health plans and 58 medical groups in California and the Pacific Northwest. The information, first gathered in 1996, will be updated again next year.
Granted, useful comparisons of physician performance are limited because of the different ways organizations gather and report data. This state of confusion serves to protect the status quo and is welcomed in some quarters. But several organizations, including the Foundation for Accountability and at least three major accrediting groups, are working to create standardized performance measures.
The American Medical Association sees the handwriting on the wall, but its American Medical Accreditation Program, touted as a one-stop source of data on physician quality, is strictly voluntary and after 18 months its impact has been limited. Widespread commitment among medical leaders is needed to give consumers the tools to make educated decisions about caregivers.