WASHINGTON, July 22, 2009 – A pilot program has shown the national feasibility of conducting scientifically valid surveys of patients and giving the public ratings and reports by patients on how well their doctors listen and explain things, make themselves available for appointments and care when needed, arrange to have helpful and courteous office staff, and perform on other important aspects of care that patients can judge.

Consumers' CHECKBOOK/Center for the Study of Services, a nonprofit consumer organization, today released ratings and reports on hundreds of individual doctors in each of three metropolitan areas—Denver, Kansas City, and Memphis. The pilots have demonstrated a low-cost, rigorous survey method that can produce such ratings and reports on most doctors in the U.S.

"The surveys gather information consumers want most when choosing a doctor or evaluating a current one," said Robert Krughoff, CHECKBOOK's president. "And the information we are reporting can motivate and guide doctors in improving their practices."

Research shows this information is medically important. For example, listening and explaining things are essential for getting the right diagnosis, getting patients to do their part in prevention and care, and letting patients share in decisions about whether to have tests and treatments. Doctor-patient communication, according to CHECKBOOK, is essential not only for quality but also for cutting costs by eliminating wasted care.

The surveys use questions and a survey procedure developed by the U.S. Agency for Healthcare Research and Quality and endorsed by the National Quality Forum. These are the first large-scale surveys to use these methods for public reporting on individual doctors.

National and regional health plans, local employer and healthcare coalitions, and local medical societies cooperated to make this information available to consumers and doctors.

The sample of patients CHECKBOOK surveyed for each doctor was selected with the collaboration of major national health plans—Aetna, UnitedHealthcare, CIGNA HealthCare—and leading regional plans—Blue Cross and Blue Shield of Kansas City, BlueCross BlueShield of Tennessee. Collaborating on the surveys was an efficient way for these health plans to get physician information and be sure that such information would be available to physicians and health plan members. If each health plan tried to do such surveys on its own, there would be many doctors for whom they could not get sufficient numbers of patients to survey, they would duplicate costs, and they would take up much more patient time responding to surveys.

The reports on doctors are available free to the public at a CHECKBOOK website (www.checkbook.org/patientcentral) and also through the website of a healthcare coalition in each metro area—the Kansas City Quality Improvement Consortium (www.kcqic.org), the Colorado Business Group on Health (www.coloradohealthonline.org), and (in the near future) Healthy Memphis Common Table (www.healthymemphis.org). The coalitions in Kansas City and Memphis are grantees of the Robert Wood Johnson Foundation's Aligning Forces for Quality initiative, a national program working to lift the quality of care in local communities.

There are increasing numbers of websites that collect and report patient ratings of doctors. But most have fewer than five reports on most physicians. At many of these websites, it is possible for anyone (even a doctor or the doctor's staff) to "stuff the ballot box."

In contrast, CHECKBOOK's reports are based on statistically valid numbers of completed surveys—for example, an average of 58 completed patient surveys per doctor for more than 700 doctors in the Kansas City area. And CHECKBOOK randomly sampled patients and verified that each had seen the doctor within the past 12 months. "The rigorous survey design has enabled us confidently to identify real differences among doctors," said Krughoff.

The CHECKBOOK website has ratings and reports on primary-care physicians (family practitioners, internists, geriatricians, and general practitioners) who care for adults—710 doctors in Kansas City, 475 in Denver, and 430 (including obstetricians/gynecologists and cardiologists) in Memphis. The same survey model works for pediatricians and for many other adult specialties. CHECKBOOK expects to include other specialties when it does the survey in New York City this fall.

CHECKBOOK's website also has extensive advice, videos, checklists, and other resources to help doctors improve and to help patients do their part—especially in communicating with physicians. CHECKBOOK expects that, as the survey spreads around the country, physician leaders will put together quality improvement programs, as they are doing in the pilot communities.

"With its new large-scale survey of patients' experiences with physicians, CHECKBOOK has shown that this effort is feasible and that its results can help consumers make informed decisions and improve quality," said Carolyn Clancy, M.D., Director of the U.S. Agency for Healthcare Research and Quality. "I am particularly pleased that this survey is based on questions and procedures that were scientifically developed by AHRQ-funded researchers."

"Consumers want information to help them find a good doctor," said John Rother, Executive Vice-president for Policy of AARP. "AARP commends CHECKBOOK and the participating health plans for making available reliable information on how patients experience care in their doctors' offices. Now that CHECKBOOK has successfully demonstrated it is feasible and economical to obtain this information, we hope that health plans in other parts of the country also will offer consumers this type of information about their doctors."

"This initiative provides important information to patients about care they can expect to receive in a particular physician's practice," said Colorado Medical Society President Ben Vernon, M.D. "Transparency in the healthcare system is paramount. We expect this information not only to be helpful to the patients, but also to all of the physicians. After all, achieving good outcomes for our patients is about working together."

James Guest, President and CEO of Consumers Union, publisher of Consumer Reports, said: "The information provided by Consumers' CHECKBOOK represents a significant advance in evaluating individual physician performance. Use of a robust survey methodology, involving responses from significant numbers of patients, assures both doctors and patients that the information provided about experiences with a doctor is more likely to reflect that doctor's usual performance."

"We are excited that two communities that are grantees of the Robert Wood Johnson Foundation's Aligning Forces for Quality initiative are involved with CHECKBOOK in this ground-breaking effort," said John Lumpkin, M.D., Senior Vice President and Director of the Health Care Group for the Robert Wood Johnson Foundation. "Collecting and reporting data publicly will help consumers make better healthcare decisions and engage doctors to use this information to improve the quality of care for their patients."

"Patient- and family-centered care is a key goal of healthcare reform, and we can't get there without asking patients about their experience receiving care," said Debra Ness, President of the National Partnership for Women and Families. "Patient experience surveys, like the one piloted by CHECKBOOK, can help patients make better healthcare choices and help healthcare providers make needed improvements. Patient experience surveys play a central role in both the assessment and improvement of care by asking the right questions and providing critically important information for both patients and providers."

"This kind of collaboration helps reduce respondent burden, increases reliability and survey quality, while giving consumers more robust information about other patients' experiences with doctors," said Helen Darling, President of the National Business Group on Health. "We won't solve many of the health system's problems without engaged consumers, so reliable, objective resources that help consumers be more engaged and find the best doctors are so valuable."

"Consumers' CHECKBOOK's new project will bring important information to patients and their doctors and, in the process, take a giant step toward the creation of patient-centered health care," said Karen Ignagni, President and CEO of America's Health Insurance Plans.

"A patient's experience with healthcare is an important indicator of quality. When doctors and nurses connect and engage with their patients we see better patient outcomes and lower costs," said Janet Corrigan, President and CEO of the National Quality Forum. "As patients, we're often flooded with choices about healthcare. The patient experience of care data made available by Consumers' CHECKBOOK allows consumers to compare providers across town or in other states to make more informed choices about their healthcare."

"We congratulate Consumers' CHECKBOOK on this effort to provide CAHPS data to the public," said Kevin Weiss, M.D., President and CEO of the American Board of Medical Specialties. "It is important for patients to have objective information about how other patients experience care. Through this program, Consumers' CHECKBOOK is beginning to demonstrate how thoughtfully collected patient survey data may be made accessible to both physicians and their patients."

Sam Ho, M.D., Executive Vice President and Chief Medical Officer for UnitedHealthcare, said, "Consistent with what our members tell us, as well as with the Institute of Medicine's focus on patient-centered care, consumers want - and need - to play an active role in making decisions about their own healthcare. The Consumers' CHECKBOOK program provides an equitable, efficient way for consumers to both generate and access meaningful information about the quality of care that doctors provide. UnitedHealthcare is pleased to be a partner in this initiative, which complements our company's efforts to give people access to information that helps them make informed choices and lead healthier lives."

Jeffrey Kang, M.D., CIGNA Chief Medical Officer, says that, "People tell us that they want objective data on a doctor's 'beside manner" and things like how long the wait at the office is, in addition to the information we already provide about quality of care measures and costs. Does the doctor communicate well? Does he or she treat the patient with respect? Does he or she clearly explain options for treatment? People care deeply about these aspects of their care, and CIGNA is pleased to be taking part in this pilot so we can develop ways to give people more of the information they want when they are making decisions about their choice of a doctor."

"This pilot program is a logical expansion of BlueCross BlueShield of Tennessee's own physician quality and cost transparency program," said Robert Mandel, M.D., Senior Vice President of Health Care Services at BlueCross BlueShield of Tennessee. "Collaborating with other health plans to the benefit of our members is a healthy precedent to set and represents tangible progress towards a reformed health care system."

"This collaborative effort involving the Kansas City physician community provides patients a wonderful resource to help them fulfill their own health needs and personal requirements in caring for themselves, their families, and other loved ones. We applaud these efforts. In this age of consumerism, we all need to be looking for ways to better serve our customers," said Blake Williamson, M.D., Senior Medical Director, Blue Cross and Blue Shield of Kansas City.