Consumer Reports starts rating primary care practices

Primary care physician practices in Massachusetts are the first to be rated by Consumer Reports in an effort the magazine plans to expand to other states.

Massachusetts subscribers received a 24-page insert in their July issue bearing the headline “How Does Your Doctor Compare?” The report on 329 physician group practices for adults and 158 pediatric practices represents a two-year partnership between Consumer Reports and Massachusetts Health Quality Partners, an organization that focuses on spurring quality of care improvements.

The report was developed with the help of a grant from the Robert Wood Johnson Foundation, as part of its Aligning Forces for Quality Initiative. The initiative is funding similar projects in at least two other states. A special report on clinical quality data on Minnesota physician practices is expected to be published in late summer, and a report on prevention activities by Wisconsin physician practices will come out in early 2013.

The three reports represent the first efforts by Consumer Reports to rate primary care physician groups and will serve as learning tools as the magazine considers developing ratings in other states, said John Santa, MD, MPH, director of the Consumer Reports Health Ratings Center.

“This is a journey, not a destination,” Dr. Santa said. “Part of this process is to try different things each time to judge how best to do them.”

Through the Massachusetts partnership, MHQP is able to extend its reach and share its data with the magazine’s Massachusetts subscribers. The ratings were compiled from MHQP surveys of 64,095 state residents about their experiences as patients.

The goal is to help improve the patient-physician partnership, said MHQP Executive Director Barbra Rabson, MPH.

“We’re all in the midst of transforming our health care systems, and we all talk about how important it is for these systems to be patient-centered,” Rabson said. “I don’t know how we can design a patient-centered system without listening to patients.”

The Massachusetts Medical Society lauds the effort, but MMS President Richard V. Aghababian, MD, said he would have preferred that the magazine not use the same format it does for all of its ratings.

“I think they could vary it a little bit for evaluating physicians and health services,” he said. “Rating appliances and vehicles is different than rating an interaction between a team of physicians, patients and family. You can’t compare personal interactions with machines.”

Dr. John Santa said the layout and symbols are designed to give readers a lot of information quickly.

“This is a format that has been developed over 75 years, and it’s a format that our subscribers immediately recognize and identify,” he said. “We want to make it easy for our subscribers to understand who’s done well and who has not.”

MHQP has been measuring patient experiences since 2006, and there have been improvements in care as a result, Rabson said. Many physicians expressed enthusiasm about the Consumer Reports ratings, especially because of the massive amount of less-reliable information available on the Internet, she added.

“Doctors appreciate that this is really a methodologically sound method,” she said.

What the ratings examined

All of the practices rated have three or more physicians. Survey questions covered six general areas of the patient experience: communication; coordination of care; how well physicians get to know patients; the patient’s experience with office staff; whether the physician advised the patient on staying healthy; and pediatric care.

Overall, respondents were more likely to recommend pediatric practices than those that treat adults.

About 60% of patients said they sometimes had to wait more than 15 minutes to be taken to an exam room, and 38% couldn’t always get after-hours advice about immediate health concerns.

High-scoring practices were found statewide, and most practices earned top ratings in multiple measures, according to the report.

Though the report includes valuable information, the ratings fall short in some areas, said Dr. Aghababian, professor and founding chair of the Dept. of Emergency Medicine at the University of Massachusetts Medical School.

“For me, what’s not addressed in this is the patient side of things,” he said. “Has the patient received the information and education they need, and are they doing what they were advised to do?”

Dr. Santa said physician ratings are a work in progress. The magazine already has ratings of thoracic and heart surgeons, hospitals and insurance companies. But there are 500,000 full-time physicians and 400,000 part-time physicians nationwide.

“Rating 900,000 folks is something that you have to do in a very careful way,” he said.