Performance Ratings for Medical Doctors: Why the Absence of a Standardized System?
Why Don't MDs Have Performance Ratings Like Chess Players Do?
Many medical doctors, especially primary care practitioners, are subject to ongoing evaluation for their adherence to certain clinical best practices compared to their peers. However, this evaluation process is not nearly as standardized or publicly visible as that for chess masters.
A Lack of Public Pecking Order
There is no public ranking or universally agreed-upon rating point system for medical doctors, in contrast to the highly structured rating point system used for chess masters. This absence of a formal, transparent system leaves many primary care practitioners in the dark regarding their performance and standing within their field.
Continuous Evaluation and Incentive Programs
Many primary care practitioners are constantly evaluated based on their compliance with certain clinical best practices compared to their peers. These evaluations are often used to decide rewards or penalties by various payors through what is known as Physician and Group Practice Medicare Programs (P4P).
Opacity and Technicality
These performance numbers are not widely visible due to the highly technical nature of the programs involved. Practitioners may use these programs to assess their performance but the information is often not made public. This opacity can make it difficult for patients and the general public to gauge the quality of care provided by individual medical practitioners.
Opinions on Effectiveness and Appropriateness
As with many forms of healthcare reform, opinions vary widely as to the effectiveness or appropriateness of these performance evaluation programs. Some argue that they encourage best practices and improvement in medical care, while others believe they may lead to increased administrative burden and potential for gaming the system.
Examples of P4P Programs
The RAND Corporation provides valuable insights and articles on Physician and Group Practice (P4P) evaluation programs. These resources highlight the diversity and complexity of the programs in place and their potential impacts on healthcare delivery.
Conclusion
While MDs do engage in various forms of performance evaluations, these evaluations are not as transparent or standardized as those for chess masters. The lack of a public ranking system and the opacity of current programs create challenges for both practitioners and patients. As we continue to navigate healthcare reform, it may be important to consider the appropriateness and potential benefits of adopting a more structured and publicly visible performance rating system for medical doctors.