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Fam Pract Manag. 1999;6(9):8

One of the more intriguing press releases I've received lately came from Healthgrades.com, self-described as “a new, one-of-a-kind Internet service that accurately and objectively rates the performance of health care providers and insurers across the United States.” When I checked out the site, I discovered that it offered a database of “leading physicians” in various specialties. Naturally, I checked to see whether my family physician was a leading physician. She is, I'm happy to say.

So physician report cards are not only here, it seems; they're already online for all. I bet you're already wondering if you, too, are a leading physician. As it turns out, there's a good probability that you are. I discovered that 58 percent of family physicians within 25 miles of my home are leading physicians, leaving only 42 percent to be what I guess must be following physicians.

And what makes you a leading physician? “Leading physicians are all board certified in their declared area of practice, have been in practice more than two years, are affiliated with a three-, four- or five-star hospital, and do not have any sanctions against them,” according to the Web site. Hmmm. Not much to it, is there? Discounting for a moment the fact that some excellent family physicians who are not board certified are apparently denied leading status, it doesn't seem to be too hard to be a leading physician — or to mean that much.

And there's more, if you listen to family physicians who have visited the site. Here are some comments from a recent e-mail list discussion:

  • “There's a privacy policy for visitors, but not for the doctors whose information they list without obtaining consent!”

  • “Not one of the family physicians in Cheyenne, Wyo., is listed, although all are board certified and have been in practice for up to 20 years.”

  • “About two thirds of physicians listed [for my city] are residents who have graduated and are no longer here.”

  • “I was happy to see that I am a leading physician … even though my hospital affiliation was not available and sanction data was not available for my state. My profile was woefully out of date and/or just plain incorrect.”

  • “I visited your site and searched for family physicians in [a specified ZIP code]. NONE of the listings that came back were completely accurate.”

If the experiences reported by these physicians are common, Healthgrades.com may be one more case of the old computer maxim: “Garbage in, garbage out.” Only here, by virtue of the power of the Internet, it might be more appropriate to say, “Garbage in, universally accessible physician report cards out.” A powerful thing, the Internet. Too bad that power is so precocious that it is not accompanied by the power to assemble accurate, clinically relevant, patient-oriented information about the quality of physicians.

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