The main hurdle to evaluating individual doctors is collecting information to rank them. While HMOs can collect data on thousands of patients with similar conditions, focusing on a single doctor brings in statistical complications.
Answers might come eventually. According to David Lansky, president of the Foundation for Accountability, an Oregon-based nonprofit organization that focuses on health care quality issues, strategies are being developed for measuring doctors' competency across the board, regardless of their care of specific medical conditions.
Meanwhile, in the absence of doctor rankings, a patient need not pick a physician at random. Cheryl Damberg, director of research and quality at the Pacific Business Group on Health, suggests that once a doctor's basic credentials have been checked, the patient should investigate the next available quality indicator: the medical group to which a physician belongs.
In California, three health plans currently publish ratings of affiliated medical groups. Orange County-based PacifiCare Health Systems publishes ratings for 187 physicians groups that provide care for its 2.3 million members. The list, at http://www.healthscope.com, ranks groups on performance in several areas of preventive care. They also include information on how satisfied members are with the plan and their primary care physician.