Data on Doctors

Data On Doctors To Be Available

RICARDO ALONSO-ZALDIVAR

Los Angeles Times August 30, 2007 WASHINGTON

Whether it's a hernia repair or heart bypass, doctors who perform a given operation more frequently get better results. The problem for patients has been finding out who those physicians are before picking one.

Now a court ruling appears to open the way for consumer access to such information for the first time, possibly transforming the relationship between doctors and their patients, as well as the business of health care.

In a little-noticed decision last week, a federal judge in Washington ruled in favor of a consumer group that sued the Health and Human Services Department to allow disclosure of doctor-level detail from the vast Medicare claims database. U.S. District Judge Emmet G. Sullivan concluded "a significant public benefit" could be served by releasing the data, and ordered the department to turn it over by Sept. 21.

With information on more than 40 million patients and 700,000 doctors, the Medicare database is far richer than any private insurer's. Although it would not have information on some doctors, such as pediatricians, who don't treat Medicare patients, it is considered the mother lode for data on those who treat adults, because Medicare recipients are a mainstay of most practices.

The database's usefulness has been limited by a decades-old government policy that protects the privacy of doctors, who fear the information could be used to micromanage the practice of medicine. But as the cost of medical care has skyrocketed, employers, insurers and consumer groups have pressured the government to open up Medicare's files on individual doctors.

Those files could reveal far more than how many times a year a surgeon performs a hip replacement operation. The data could also be analyzed to determine how individual doctors make critical decisions on tests and procedures that determine both quality and costs. They would show which doctors fail to order prudent preventive tests that could catch disease early. And they could indicate which ones order duplicative tests or unnecessary hospitalizations...

...Those files could reveal far more than how many times a year a surgeon performs a hip replacement operation. The data could also be analyzed to determine how individual doctors make critical decisions on tests and procedures that determine both quality and costs. They would show which doctors fail to order prudent preventive tests that could catch disease early. And they could indicate which ones order duplicative tests or unnecessary hospitalizations.

"These data will make it possible to develop measures that will be very helpful to consumers," said Robert Krughoff, president of Consumers' Checkbook, the nonprofit group that sued for the information.

"Someone who is thinking they need a knee replacement--or a prostatectomy--will be able to go on our website and see how many of these procedures their physician has done for Medicare patients," added Krughoff.

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