I always know I’m in for a treat when Inga sends an article my way. She didn’t disappoint with Industry jeers peer-nominated Top Doctors list.
Earlier this month, I shared my thoughts regarding websites where patients can rate their physicians. Now it seems the intrepid staff at US News & World Report has gotten into the game.
Most people are familiar with the “Best Hospital” list they put out every year, with the same academic medical systems filling out the top of the list year after year, but with slight reordering. Having trained in some of these institutions, I’m not sure what it really means, but the hospitals sure do like to brag about it.
The physician list is the result of a peer nomination process. It reflects no data on training, experience, board certification status, or disciplinary action. I looked up physicians in my specialty within 25 miles of my ZIP code and found a couple of docs I know. One of then I deeply respect and would trust with a member of my own family.
The other I can only describe as seriously out of date, with a reckless disregard for evidence-based medicine. He’s one of those “great guy” types, but as someone who used to work with him very closely, I couldn’t believe it.
There’s a link in the article to the methodology used in the rankings. The comments section was truly enlightening. They include:
Very disappointed with this list. I have been chief of my department for many years now and know of at least one MD on your list who has had substance abuse problems and has been put on limited restrictions. This is clearly an imperfect and potentially dangerous system that needs some review of its rating system.
While many of the physicians you recognize in your list that practice in the same subspecialty as myself, there is one who is recognized that I have personally worked with and know lacks certain ethical standards in the operating room.
US News isn’t the only news outlet to get into the physician rankings game. One of our local magazines has been doing it for years, to the great amusement of many docs in the area.
One of our colleagues who hasn’t practiced in the area for almost a decade continues to make the list year after year. When we are polled for nominations, we take great pleasure in continuing to nominate her just so we can send her a copy when she makes it again. She hates being on that list — it makes her a magnet for patients unhappy with their current physicians or those expecting miracles.
While I was looking at the rankings, I couldn’t help but think about the recent EHR usability ratings I covered last week and about ratings of systems in general. KLAS is often cited when discussing EHR ratings.
My first experience with KLAS was when I was solicited by a vendor’s project manager for a newly-implemented system. It reminded me of the annoying service rep at the car dealer who always tells me, “If they call, give me all high-fives!” as he hands over my keys. The project manager asked me if I could give the vendor eight or higher on a 0-10 scale. If so, she would see that I received a KLAS survey. She didn’t specify what would happen if I couldn’t give it that kind of a rating.
Luckily, this was one of our stronger vendors who legitimately deserved high scores, so I agreed to participate. But I found the idea that vendors were able to choose who rated their products to be unsavory. (I don’t think KLAS does it that way any more, at least not exclusively, since I found a ‘rate your vendor’ button on their website. Some of the KLAS questions are still somewhat subjective, though.)
Regardless, I’m not sure any of the more objective analyses are able to differentiate products any better. ONC-ATCB lists 164 certified “Complete EHR” systems for Eligible Providers, of which 53 are also CCHIT certified for 2011. This proves that a system contains certain functionality, but doesn’t say much about its ability to improve the patient or physician experience, let alone deliver higher quality care or lower healthcare costs, the reasons most often cited for making the leap to EHR in the first place.
I’m not sure what the answer is. As a clinician, it’s hard to rate clinical systems unless you’ve used more than one. The grass always seems greener on the other side until you actually have to use another system.
For large health systems or multispecialty groups, the functionality expected of EHRs grows every day. There’s no way a single vendor can be good in every specialty and every size practice. But they definitely try and it’s certainly entertaining to watch.
Have a foolproof methodology for ranking clinicians or vendors? E-mail me.