Opinion: Derms concerned about release of of statistical data

March 1, 2008

The U.S. Department of Health and Human Services is appealing a Federal Court order requiring the release of information about the number of Medicare claims filed by individual physicians. The order was the result of a Freedom of Information Act lawsuit filed by Consumers' CHECKBOOK/Center for the Study of Services, a nonprofit consumer research and information organization.

Key Points

The U.S. Department of Health and Human Services (HHS) is appealing a federal court order requiring the release of information about the number of Medicare claims filed by individual physicians.

The order was the result of a Freedom of Information Act lawsuit filed by Consumers' CHECKBOOK/Center for the Study of Services, a nonprofit consumer research and information organization.

The HHS says it doesn't oppose patient access to the information, but previous court rulings have prohibited the release of physician-identifiable data.

Consumers' CHECKBOOK contends the information would help people assess whether the government is paying unqualified physicians to do large numbers of high-risk surgeries, or if a lot of patients are getting procedures from doctors who don't do enough of the procedures to maintain needed skills.

The doctor's perspective

On Call asked dermatologists whether they like of the idea of releasing those statistics to the public, and whether patients have a "right" to those figures.

Several of the physicians who spoke to On Call have no real issue with patients getting information to help them make wise medical choices.

However, one set of doctors could find themselves on the short end of that numerical listing through no fault of their own, says Brian G. Sandler, M.D., in Shelby Township, Mich.

"In essence, there's really nothing wrong with publishing the data, although I think you'd expect younger physicians to have less experience in procedures than the older physicians who have had more time to gain proficiency," Dr. Sandler tells Dermatology Times.

If patients avoid young physicians because they don't have the numbers, it could make it harder for them to get the experience.

In Portland, Ore., Douglas Key, M.D., actually thinks outcome statistics make more sense than simply total case numbers.

"I know of several plastic surgeons who have had deaths on the operating room table. They have large numbers of procedures. So, what is more important, the larger number of procedures or that they've had several deaths?"

Dr. Key says the complexity of the issue doesn't take into account other concerns doctors - particularly surgeons - would face.

In Celebration, Fla., Dean R. Goodless, M.D., isn't convinced that patients would necessarily find the Internet publication of this generic data useful.

"I think this would have a minimal effect. The vast majority of patients wouldn't avail themselves of the information.

"A lot of patients only care about one thing - whether we're on their insurance plan," Dr. Goodless says.

In practice for 10 years, Dr. Goodless says Celebration attracts many patients because of its reputation for medical care excellence.

"But when I ask patients how they heard about the practice, about a third look in their insurance book and they can see us for free.

"Another third heard about us from a friend, which means we made a patient happy. That's a good referral.

"The other third are primarily referred by another doctor, so I don't see that having that information online is going to drastically alter the way patients pick their doctors."

Beth A. Honl, M.D., in Fargo, N.D., has reservations about putting individual physician information out on the Internet. She thinks too much is already out there for people to use.

"It may be a little paranoia on my part, but I've been battling identity theft for several months. The idea of putting anything else out there with any kind of identifying information makes me very uneasy.