Profiling physician practice: a potential for misuse

Area of Science:

• Healthcare Management
• Epidemiology
• Surgical Quality Improvement

Background:

• Physician profiling is a known practice for hospital epidemiologists.
• Surgeon-specific postoperative wound infection rates are used for quality monitoring.
• Concerns include small sample sizes, risk adjustment validity, and data reliability.

Purpose of the Study:

• To examine the role and challenges of physician profiling in healthcare quality improvement.
• To discuss the impact of methodologic concerns on physician profiling.
• To consider the future of physician practice scrutiny amidst healthcare reform.

Main Methods:

• Review of existing literature on physician profiling and surgical outcomes.
• Analysis of methodologic challenges in risk adjustment and data collection.
• Discussion of the influence of healthcare reform on regulatory oversight.

Main Results:

• Physician profiling, particularly surgeon-specific infection rates, has been utilized for quality assessment.
• Significant methodologic concerns have led to varied opinions on its effectiveness.
• Despite concerns, regulatory and managerial pressures favor increased scrutiny of physician practice.

Conclusions:

• Methodologic limitations in physician profiling are acknowledged.
• Healthcare reform and skepticism towards physician decision-making are driving increased oversight.
• Expanded scrutiny of physician practice is anticipated despite existing challenges.