Physician Characteristics Do Not Predict Quality of Care

“How do I determine who is the best doctor?” That is the question that is on every patient’s mind. Unfortunately, research has shown that, for the most part, there are few characteristics of physicians that patients can use to accurately and reliably estimate the likely quality of that physician’s performance.

To make matters worse, information on physicians' performance on measures of clinical quality is rarely available to patients. And even the small amount of comparative quality data that is available does a poor job in accounting for acuity differences among patients, meaning that trying to compare physician performance is often like comparing apples to oranges

It's a shame, but all most patients have to go by is whether the doctor is “nice,” where did they get their training, did they pass their Boards, and have they been sued frequently.

A study published recently in the Archives of Internal Medicine bears this out. In “Associations between Physician Characteristics and Quality of Care,” Reid, Friedberg, Adams, et al. “examined the relationship between physician characteristics and performance on a broad range of quality measures.” The authors “calculated overall performance scores on 124 quality measures from RAND's Quality Assessment Tools for each of 10,408 Massachusetts physicians using claims generated by 1.13 million adult patients.” They assessed associations between physician characteristics and overall performance scores using multivariate linear regression.

They found that three physician characteristics “were independently associated with significantly higher overall performance:” female sex, board certification, and graduation from a domestic medical school. The authors reported finding “no significant association between performance and malpractice claims.”

Based on this data, the authors concluded that “Few characteristics of individual physicians were associated with higher performance on measures of quality, and observed associations were small in magnitude. Publicly available characteristics of individual physicians are poor proxies for performance on clinical quality measures.”