A pilot program has shown the feasibility of conducting scientifically valid national surveys of patients regarding their doctors and providing the reports publicly.
Consumers' Checkbook/Center for the Study of Services (CSS), a nonprofit consumer research organization, surveyed patients in Kansas City, Denver, and Memphis.
"For example, listening is essential to good diagnosis, explaining things is essential if patients are to know how to comply with a treatment plan and be motivated to do so, and both listening and explaining are important if we believe in shared decision making," says Robert Krughoff, Checkbook's president. "Falling short on these dimensions represents waste—with incorrect diagnoses, failure of patients to comply and decisions to do treatments that informed patients wouldn't want."
The surveys use questions and procedures developed by the Agency for Healthcare Research and Quality and endorsed by the National Quality Forum. In Kansas City, for example, the online reports are based on an average of 58 completed patient surveys per doctor. To select the patients to survey, Checkbook/CSS identified patients who had visits with each doctor within the preceding 12 months based on claims records. This sampling was done in collaboration with Aetna, UnitedHealthcare, CIGNA HealthCare, Blue Cross and Blue Shield of Kansas City, and BlueCross BlueShield of Tennessee.
Participating plans also agreed to license the survey results for a fee to use as they see fit. (Non-participating plans will not be granted use of the survey results.) According to the company, the survey model costs about $100 to $120 per doctor.
Aetna's Chief Medical Officer Lonny Reisman, MD, believes the approach improves the health plan's ability to gather sufficient patient feedback on each doctor to provide scientifically valid and meaningful information.
"The more people weighing in, the more credible and useful the information will be," Dr. Reisman says. "Sharing reliable patient input with doctors and consumers adds a valuable dimension to existing tools that engage health plan members by helping them evaluate quality as well as cost."
Physicians in the pilot metro areas have been cooperative in survey efforts, says Krughoff.