Disclosure of physician information
Public disclosure of hospital, and physician information was in the past considered unprofessional. However, gradually the practice has come to be considered a measure of improving quality of health care and an empowerment media of patients in making informed medical decisions. This would especially be beneficial in the field of surgery where the patient would be able to make an informed decision regarding who to seek care from given the potential risks and benefits posed (Petronio, 2000). Report cards can be used to administer physician quality and efficiency ratings. The relevant authorities, health plans and other such institutions then remain with the responsibility of making this information publicly available. This paper will consider the fairness of report cards and whether they are balanced or not.
The type of information found in the physicians report cards includes disciplinary records; the number of procedures performed by the physician, whether or not the physician in question has lost hospital privileges and reported instances of malpractice. The physician report cards are fair and balanced. It has succeeded in addressing the interests of both the physicians and the patients. The patients have been able to benefit from the report cards as they have increased the patients autonomy (Laura, 2010). Patients have therefore, had clear facts and statistics on which to make proper decisions with regard to the procedure they should accept and which physician to entrust with their health. Physicians have much influence on the outcome of any medical procedure. Therefore, having the patients aware of information on physicians gives them responsibility to choose the most appropriate physician for them.
Another manner that the report cards have benefited patients is the improvement in the quality of healthcare services. In order to maintain a clean and rich scorecard, physicians ensure they offer exceptional services to their patients. The healthcare consumers therefore get to receive improved healthcare services. The Memphis healthcare sector has for instance put this program on the fore front with the aim of catalyzing efforts in quality improvement.
The physicians benefit from this through motivation initiated by the recognition and rewarding of efforts and merits of performing physicians (Lauren, 2010). The medical malpractices heard and reported from a number of physicians tarnish the image of even the many hard working ones. Individual evaluation of physicians will provide individual performance profiles therefore clean physicians will no longer have to suffer the mistakes of other physicians. In addition, costs of insurance cover for physicians may reduce through the report cards (Lauren, 2010). The first way that this can happen is when the cases of medical malpractices reduce in turn reducing claims to insurance companies consequentially leading the companies to lower their premium rates. Another way the insurance cover costs can be reduced is through the introduction of calculation of physician premiums through individual basis. Through the report card, the insurance provider can evaluate and compute the premiums payable by the individual physician. Clean sheets physicians will be attracting low premium rates.
The rating process in the report card rating system gives the medical practitioners a fair medium. The statistical risk adjustment modeling is utilized in the calculation of the physician performance rates (Burger, Schill, and Goodman, 2007). The application of variable case mixes allows for fairness to be practiced especially among surgeons. Usually, when the debate over the unfairness of the report cards comes up, the concern of some practitioners practicing on high risk while others practice on low risk patients arises. However, the use of variable case mixes ensures that practitioners practicing on high risk patients are evaluated differently compared to those practicing on low risk patients. This applies because those practitioners practicing on high risk patients are more likely to be penalized more than the ones practicing on lower risk patients.
The information provided in the report cards is enough for the patients to clearly make proper decision. There are people who oppose the concept that report cards provide elaborate information and argue that the information provided in the report cards can be misleading to the patients. The statistics and data provided in the report cards are significant to the decision making of the patient. The statistics provided in the report cards present information on the numbers and quality of procedures a physician has performed and the success rates of this physician. A number of studies have come up with positive findings regarding the theory that a direct and significant influence on the advantages and risks of a procedure exists depending on individual physician (Burger, Schill, and Goodman, 2007). Data concerning the capability of a medical practitioner to provide a particular medical intervention is also provided in the report cards. Access to this data would place the patient in a better position to make a decision on whether to proceed with the procedure or not.
At present, legislation requires physicians to submit information contributing to the patient giving a consent that is informed. The information here stated includes the benefits and risks of the procedure, the model of intervention and alternatives available. There are authors arguing that disclosures not containing relevant material information regarding the performance ability of available medical practitioners are not adequate basis to use in providing informed consent (Burger, Schill, and Goodman, 2007). A verdict in a 1996 court case involving Johnson Kokemoor the Wisconsin Supreme Court found that the experience and risk statistics of a surgeon actually fell under the informed consent doctrine (Petronio, 2000). The patient will is therefore not reflected in an informed consent without information on the competence of the practitioner being provided.
Information provided by the report cards is accurate and reliable. As a result it enables patients to make informed decision. The use of risk adjustment modeling makes it more efficient and reliable in the providence of performance rating among medical practitioners. The risk adjustment modeling provides rating based on a large sample and the parameters accounted for can be quantified and are easier to measure (Petronio, 2000). There are those who consider the quantitative nature of this method to be misleading. However, its efficiency in provision of uniforms standards of gauging performances of physicians is evident.
Previously, disclosure of information on physicians was not considered an appropriate or professional practice. However, the public has come to consider such a move an advantageous one as they get to be informed before they make any decision regarding which physicians to practice on them and such. The physicians report cards are one way of providing information on the performance of physicians. The report cards are reliable and balanced as they serve the interests of both the patients and the medical practitioners (Petronio, 2000). The information provided is accurate, reliable and elaborate enough for the patient to make an informed decision. Data on the number of procedures that a medical practitioner has performed is provided as well as their ability to intervene. Knowing this, the patient would be in a position to decide which physician would be best to practice on them on which procedure. The legislations presently in place require that physicians provide information that will be helpful in making the patient make a decision that is informed.
References:
Burger, I., Schill, K. & Goodman, S. (2007). Disclosure of Individual Surgeons Performance Rates During Informed Consent. Annal of Surgery, 245 (4): 507-513. Retrieved on April 4, 2011 from: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1877054/
Lauren, J. (2010). Doctors Report Cards: Innovation Healthcare through Grading. Retrieved on April 4, 2011, from: http://www.myfoxmemphis.com/dpp/news/local/112410-doctor-report-cards-innovating-healthcare-through-grading
Petronio, S.S. (2000). Balancing the secrets of private disclosures. London: Routledge
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