Rating US health care providers

I'd bet if you took a survey in the US, you'd find most people are pretty happy with their current health care provider(s). Let's face it, most people aren't sick, and even when they do get sick, their own immune systems can fix most anything on its own. For most other ailments a visit to a primary care physician can easily diagnose and prescribe the necessary action to resolve the matter quickly.

So why do we even try to rate health care providers? I for one have never been a fan of health care provider ratings, because it can't be done reliably. Health care is not an exact science. It is an art [of sorts], and trying to apply statistical measures to it are at best suspect.

Even trying to track the things that could be measured objectively, such as in patient infection rates, readmissions, etc. can't be relied upon, because in a for-profit health care system, absent of regulation (like in the US), the incentive is to skew the data to produce positive results. And you sure can't rely on data supplied by patients either, because most people aren't knowledgeable enough about medicine, and are subject to personal prejudices.

Still that doesn't stop people from trying. There's a new website being developed by a multiple myeloma survivor, attempting to present data comparing survival rates of multiple myeloma patients by doctors, hospitals and regions in order to quantify the best in each category.

Despite the well intentioned efforts I'm sure this person has, I can't help but ask myself why bother?

Certainly this information might be useful, but like I outlined above, you just can't rely on the integrity of the data, especially, as in this case, when the data is being supplied directly by the doctors and hospitals being rated.

And even if you could rationalize the integrity of the data in this instance, the number of variables that exist [and not included] are endless, and difficult, if not impossible, to quantify.

For example, how far along has the disease progressed in a particular patient? How do we know if the health care providers, with the worst survival rates, weren't just being inundated with the worst and most difficult cases? Identifying those health care providers as poor performers would not only be doing a disservice to the health care providers, but also to the patients who might steer clear of them.

And how do you quantify the aggressiveness of a disease? One thing I've learned throughout all this is, while there may only be one disease, there are numerous variants of each, some aggressive, and some not so agressive. Even if the doctors and hospitals were able to run all the tests necessary to categorize the aggressiveness of a disease (a cost which incidentally would be exorbitant), one has to keep in mind we are all different, and in any number of cases, those with poor prognostic indicators can perform extremely well, while those with good prognostic indicators can perform poorly.

Then there's age to consider. How do you factor that into account? Are all 60 year olds in the same physical condition?

[note]Just look at Joe Paterno. He died extremely quick after we first learned of his diagnosis. Do we really think he wasn't receiving the best care? Should the hospital and doctor be penalized for that?[/note]

While I applaud the effort, simply because anything that keeps cancer survivors occupied, and not constantly worrying about their fate, has to be beneficial, I would be extremely skeptical of any of the ratings provided by this website, or any similar ones.

Posting on how to be better, more informed and proactive patients (one of the original goals of this blog), in my opinion, would be time better spent.

The only way to be sure we're receiving the best possible care is to be knowledgeable of our disease. We're not all blessed with being able to see a hematologist/oncologist that focuses solely on our particular disease, so asking the right questions, and supplying your doctor(s) with up to date information is absolutely vital.

Doctors are only human. They see many patients, all presenting differently. It would be naive to think any hematologist/oncologists has the ability to keep up with all the advances in the treatment of the myriad of cancers they deal with on a daily basis.

Staying informed and helping your doctor by supplying him/her with the latest information regarding your disease is something I have found every doctor I have had contact with to be very grateful for.

All you really need to know is, a proactive patient is a good patient, and the one who will likely survive the longest!