Expert Commentary

Associations between physician characteristics and quality of care

2010 study in the Archives of Internal Medicine on link between observable physician characteristics and quality of treatment for patients.

When choosing a doctor, patients are rarely afforded the opportunity to view the doctor’s records of performance over his or her clinical history. Rather, they make decisions based on the information that is available to them, such as education, gender, nationality, publicly available malpractice history, or board certification.

In a 2010 study published in Archives of Internal Medicine, “Associations Between Physician Characteristics and Quality of Care,” researchers constructed “performance scores” for 10,408 Massachusetts physicians based on information from 1.13 million of their patients between 2004 and 2005.

The study’s findings include:

  • Female physicians scored 1.6 percentage points higher than male physicians; board-certified physicians scored 3.3 points higher than those without board certification; and U.S.-trained physicians scored 1 percentage point higher than doctors trained abroad.
  • There were no statistically significant associations between performance and number of malpractice claims, disciplinary actions, years of practice, rankings of medical school attended or type of medical degrees earned.
  • The difference in overall performance between an average physician with the best combination of characteristics (female, board-certified, U.S.-trained) and the average physician with the worst combination is only 5.9 percentage points.

The researchers conclude that, generally speaking, patients do not have data that would significantly improve the quality of their choice of physician. “Consumers are encouraged to use physician characteristics, suchas board certification and lack of paid malpractice claims,as a signal for quality,” they write. “Yet in our study, few individualphysician characteristics are consistently associated with higher quality, and when present, these associations are small in magnitudeand are generally not significant in a practical sense.”

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