We all know that the best doctors in the world are determined by how well that doctor documents the visit.
-Said No Doctor Ever!
Seriously, it’s an absurd claim that the quality of a doctor’s documentation would be how we rank the quality of a doctor. I’m sure just reading the headline probably pissed you off. I was upset just typing it. We all know that there are a lot of great doctors who are really awful at documenting. We know there are some awful doctors that’s documentation looks beautiful.
Since we all know this is the case why would I ask the absurd question about a doctor’s documentation determining their quality rating? Because I can see a path where we head this direction.
Yes, it’s scary to consider, but that’s why it’s so important that we consider it. I think this could be the impact of the quality reporting scores that come from MACRA/MIPS/APMs. It seems like it’s only just a matter of time before these scores will hit the Physician Compare website.
Don’t be surprised if they’re also made publicly available so that every health rating site on the internet pulls them down from CMS and uses them as one more factor in how they determine the highest quality doctors. If you don’t believe this will happen, then you haven’t followed what they’ve done with other CMS data.
Remember that these websites don’t have to have actual quality data. They just have to show the perception of quality data. Most consumers aren’t smart enough (or diligent enough) to know the difference. In fact, CMS itself calls it quality data, so they’ll be able to use that word freely. Imagine the doctor who gets ranked lower because their MIPS quality score was lower or non-existent because they have a small Medicare population or because they chose not to participate in the program. This is not a far fetched idea and is a fear I’ve heard from many health systems.
It’s too bad we don’t have a real way to measure quality. Then, we’d all want that data to be shared. However, I’m close to the conclusion that you can’t truly measure clinical quality. At least not in any scalable way. I’m hoping one day we’ll get there, but I don’t see it happening anytime soon. Until then, companies will use whatever perception of quality they can find and many high quality doctors will suffer because of it.