REPORT CARDS: CALIFORNIA GROUP RATES DOCTORS

       "In a path-breaking step in the effort to develop health
 care report cards for consumers, a California employers' group
 published a ranking of 50 physician groups based on patient
 surveys and their record on providing preventive care," Wall
 Street Journal reports.  The employers' group, Pacific Business
 Group on Health, hopes that the rankings will help patients
 choose doctors and health plans.  According to the Journal, the
 initiative is unusual because it focuses on doctor groups rather
 than health plans.  The project is also unusual because the
 information is being disseminated to a wider audience than just
 employees; the information will be available on the Internet and
 through a toll-free phone number.  According to Judith Hibbard,
 professor of health policy at the University of Oregon, the
 rankings of doctors groups rather than health plans are more
 relevant to patients.  She said, "Health plans are not the
 relevant unit of delivery for consumers.  Doctors are the
 relevant unit.  We're just starting to focus on how to make this
 data understandable and useful to consumers."  
 The Envelop Please
      The report ranks physician practice groups in California on
 "such factors as patient satisfaction, ease of getting referrals,
 and their record of keeping blood pressure and cholesterol under
 control and counseling patients on preventive care."  In Northern
 California, patient satisfaction was 80% among 22 doctors groups
 "while patients gave the groups a 67 on a scale of 100 for
 overall quality of care, 66 on doctor communication skills and 46
 for keeping cholesterol under control."  Patient satisfaction
 among 27 doctor groups in Southern California was slightly lower
 at 78%.  According to PBGH Executive Director Patricia Powers,
 the lower rates of satisfaction in Southern California may
 reflect the more competitive health care environment there. 
 However, she said that we should all "look at what is driving the
 dissatisfaction indicators and try to fix them."
 Doctors' Dissatisfaction
      Doctors are not all supportive of the project, although all
 the doctors groups that participated did so voluntarily.  Charles
 Lynch, medical director for the San Francisco and San Mateo
 Independent Practitioners Associations, said, "Some will feel
 threatened by patients wielding this kind of influence based on
 their perceptions.  Once that material is out there in the court
 of public opinion, it becomes the standard against which you're
 held."    
 Impact On Consumers
      Analysts say that it may be difficult for other states to
 replicate the California initiative because California has one of
 the "few markets where physicians are organized."  However,
 Margaret O'Kane, head of the National Committee on Quality
 Assurance, said that collecting "consumer information on medical
 group performance is very important."  And Journal reports that
 whether the information is useful to consumers remains to be
 seen.  According to Professor Hibbard, consumers are becoming
 more overwhelmed by the complexity of the information available,
 so it may ultimately not prove as useful as anticipated (Winslow,
 9/17).