A new kind of doctor-rating Web site?

Doctor-rating systems are about to change.

There are many Web sites that report doctor ratings, but most have fewer than five reports per physician. And at some Web sites, it is possible for anyone, including the doctor and the doctor's staff, to post positive comments or for patients to make false reports.

Consumers’ CHECKBOOK/Center for the Study of Services, a consumer information and resource organization, has developed a pilot program in collaboration with several major health plans in an attempt to show that it is feasible to conduct valid, large-scale surveys of patients rating their doctors on a variety of subjects.

The CHECKBOOK program uses questions and a survey procedure developed by the Agency for Healthcare Research and Quality and endorsed by the National Quality Forum. This rating system is the first to use these methods for public reporting on doctors.

Survey questions ask patients to rate their doctors on communication, availability, office staff, and performance on aspects of care patients can judge. In contrast to other doctor-rating Web sites, CHECKBOOK's reports are based on statistically valid numbers of completed surveys-usually more than 45 of each doctor’s actual patients.

CHECKBOOK pilots the surveys using patient data provided by participating health plans, local employer and healthcare coalitions, and local medical societies, then randomly samples patients and verifies that each has seen a particular doctor within the past 12 months.

This information is essential for getting the right diagnosis, engaging patients in their own prevention and care, and letting patients share in treatment decisions. Doctor-patient communication, according to CHECKBOOK, is essential for quality care and for cutting costs by eliminating wasted care.

The reports are currently limited to three regions-Denver, Kansas City, and Memphis-and focus on care for adults and on primary care physicians, although cardiologists and ob/gyns were included in the Memphis survey. CHECKBOOK expects to include other specialties when it does its survey in New York City in the fall and will be including more regions and more doctors in future surveys.

CHECKBOOK’s program could demonstrate that a low-cost, rigorous survey method can produce ratings and reports on most doctors in the United States. As the survey spreads around the country, CHECKBOOK expects that physician leaders will put together quality improvement programs, as they are doing in the pilot communities.

The reports on doctors are available free to the public at www.checkbook.org/patientcentral, as well as through websites of healthcare coalitions in each area.