How to Give Your Doctor and Hospital a Fiscal Checkup
Information about your doctor's medical training, board certification, and state disciplinary actions is just a click away. Healthgrades.com
Before you put your health in someone elses hands, its smart to make sure those hands are clean—bad medicine is bad for your well-being and your wallet. In addition to malpractice history, which has been made public in 16 states and counting, your doctors education, board certifications, and any disciplinary action taken against him or her by the state medical board is all publicly available information. In some states, hospitals are also required to track infection rates, safety practices, cleanliness, and patient satisfaction. Heres how to conduct a background check on your doctors and hospitals.
How to check up on your doctor
Consult your state medical board. Find the website of the medical board in your state through the Federation of State Medical Boards (FSMB) directory. Go to your states site and look for a function called “Licensee Search,” “License Verification,” or “Physician Profiles,” etc. (the exact terminology varies by state). Enter your doctors name, which, depending on the state, will pull up information on his or her medical training, licensing, board certification, professional memberships, and hospital affiliations, as well as any history of state disciplinary actions. (For a $9.95 fee, you can also access a doctors report directly through the FSMB.) In some states, such as New York and Virginia, youll also be able to see whether a doctor has had any malpractice judgments or settlements against him. With a malpractice record, you should look for a pattern. "If there is one settlement, its something to ask your doctor about. If there are three or four judgments, stay away,” says Patty Skolnik, a Colorado resident who successfully lobbied for legislation requiring that malpractice information be made available to the public in her state. (Skolniks son, Michael, died in 2004 after experiencing complications from a 2001 brain surgery.)
Quiz your surgeon. If you are choosing between doctors, ask how many times each has performed the particular procedure in the past year and what his infection rate is. “Doctors know their infection rates for different procedures, and they should be willing to share that with you,” says Betsy McCaughey, PhD, a health policy expert, former New York State Lieutenant Governor, and sole founder of the Committee to Reduce Infection Deaths.
Consider a ratings service. Among the most established and most comprehensive health-care ratings websites is HealthGrades, which provides profiles of all of the approximately 700,000 practicing physicians in the country, as well as approximately 5,000 hospitals. In addition to basic information such as board certifications and disciplinary actions, HealthGrades has other features that can help round out your sense of the doctor before you meet him, such as patient satisfaction ratings based on survey data and the quality ratings of the hospitals where the doctor practices. Some doctors have paid the site to include video of themselves discussing their philosophy of practice, an easy way to get a feel for a doctor before meeting him. The reports also note whether a doctor has received a quality designation from a nonprofit organization called Bridges to Excellence, which assesses how well doctors handle specific conditions, such as diabetes. “Ninety percent of the doctor information on the site is free,” says spokesperson Scott Shapiro.
The paid-doctor reports at HealthGrades, which start at $18, may offer some convenience. But you should know that much of the information, such as malpractice history and state sanctions, is also available for free elsewhere.
How to check up on your hospital
Visit your state department of health website. Some states, such as Florida and California, offer hospital “report cards.” (A partial list of states is available on the Consumer Reports website.) In most states, youll find data on a variety of quality measures, such as mortality rates for coronary artery bypass surgery or angioplasty. Some states, including Florida and Pennsylvania, also track hospital infection rates; hospital-acquired infections cause an estimated 103,000 deaths per year—as many as from AIDS, breast cancer, and car accidents combined, according to McCaughey.
Check out the Joint Commission. Hospital report cards can be found at the Quality Check website of The Joint Commission, a national nonprofit that accredits health-care organizations. You can review the performance of hospitals on the measures that the commission calls National Quality Improvement Goals: guidelines for surgical care and the treatment of heart attack, pneumonia, and other conditions. You can also find out whether the hospital meets accreditation standards or has received awards for quality.
Check Medicares website. As the largest payer for health-care services in the United States, Medicare has a wealth of information online through its Hospital Compare tool. The site provides information on 26 quality measures, including how well hospitals provided care for patients with heart failure or pneumonia, for example. Recently, the site added 10 new measures of patient feedback, including how clean patients said their rooms were.
Look into a professional hospital-ratings service. Among the best of the websites for hospital ratings is the nonprofit Leapfrog Group. The site surveys hospitals to see whether they implement important safety measures such as computerized drug systems, which one study has shown to reduce errors by 86%. “Leapfrog is excellent, but its hard to find a Leapfrog—recommended hospital. There are not that many of them around,” says McCaughey. HealthGrades, which partners with Leapfrog for some hospital measures, provides a different perspective on hospital quality by measuring how well patients did after approximately 30 different diagnoses and procedures, ranging from coronary bypass to knee replacement surgery. According to HealthGrades research, patients treated at hospitals rated in the top 5% on its website are 27% less likely to die than those admitted to other hospitals. And patients who undergo surgery at these top-rated hospitals also have, on average, a 14% lower risk of complications during their stay.