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H O W W E L L D O Y O U K N O W Y O U R H E A L T H C A R E P R O V I D E R ?

July 22, 2007|Daniel Costello | Times Staff Writer

Even in this digital age -- when one can get the temperature in Kuala Lumpur or the Zuma Beach surf report at the click of a button -- most people still rely on word of mouth to pick their doctor or check up on their local hospital.

Others choose from lists provided by their health plans, cross their fingers and, well, hope for the best.

Increasingly, insurers, the government and other sources are providing information, especially on the Internet, about the quality of the nation's doctors and hospitals -- details that were simply unavailable a decade ago.

"The fact is healthcare consumers need more information," said Sarah Loughran, executive vice president of Health Grades Inc., a healthcare rating company. "Can you imagine buying a car and not being able to research it beforehand?"

Many of the more sophisticated tools are still in their early stages and the information they provide can be incomplete. Some can also be hard to understand unless you're a statistician or have a medical degree.

With a little homework, though, consumers can get their hands on all kinds of information.

Georgina Petruzzi of San Clemente hired a new service, PinnacleCare, last year to help her find a doctor for a second opinion. After Petruzzi gave birth last summer, her endocrinologist suggested she go on medication to treat her gestational diabetes, something she didn't want to do.

The company, which charges clients for individual requests or through annual memberships that range from $2,500 to $30,000, helped her find a specialist in Los Angeles who later decided her endocrinologist misdiagnosed her, and so never put her on medication.

"He listened to me and explained why the meds weren't necessary," said Petruzzi, whose diabetes has subsided.

Experts say more patients should do such research. Last week, a study from the Harvard School of Public Health found that patients who went to hospitals ranked higher according to specific quality measures had a lower chance of dying than patients at lower-ranked hospitals.

The researchers calculated that if the lowest-performing hospitals had similar patient mortality rates to those of top-performing hospitals, 2,200 fewer elderly Americans would die each year.

"More transparency about the quality of care helps patients make more informed decisions" said Maribeth Shannon, director of the Market and Policy Monitor program at the California HealthCare Foundation.

How to check up on your doctor

A good place to start is with the state medical board. It generally provides the basics of a doctor's biography, location and education.

On the website of the Medical Board of California (www.mbc.ca.gov), you can find out, among other things, whether a physician has been accused of wrongdoing, been disciplined by the board, or made repeated medical malpractice settlements within the last decade.

There are other databases connected with insurance companies, the government and private firms that publish doctor and hospital ratings.

Aetna Inc.'s Aexcel network, for example, is made up of doctors the insurer encourages members to visit -- based on clinical performance and cost of care. Doctors are graded on factors such as how well they follow best medical practices and their patients' hospital readmission rates.

Next year, UnitedHealth Group Inc. is expanding a similar network, UnitedHealth Premium, to the West Coast. Others are expected soon.

(Insurers' rating systems can be controversial: The New York attorney general's office this month asked UnitedHealthcare, a unit of UnitedHealth Group, to stop the planned launch of such a network there, citing critics' accusations that the rankings primarily reflect the cost of care to the insurer, not patient care. The insurer denies that.)

Health Grades (www.healthgrades.com) offers reports that list doctors' medical training and any recent disciplinary actions. Some information is free, although there's a fee schedule for more detailed records that starts at $18.

"Doctors can add their personal information and allow patients to set up appointments on the site," said Loughran of Health Grades.

California's Office of the Patient Advocate (www.opa.ca.gov) rates medical groups and offices -- rather than specific doctors -- by surveying patients.

Consumers' Checkbook (www.checkbook.org) is a local rating service that includes doctors. The company, which also rates services such as dry cleaners and car dealerships, asked about 260,000 physicians which specialists they would want to care for a loved one.

This database lists the 20,000 specialists who were mentioned most often. It's available online or as a book for $24.95.

How to check up on your hospital

Hospital choices are made in many ways. Patients often take the advice of their doctor or surgeon; some prefer the hospital closest to their home; accident victims are usually taken to the nearest trauma center.

Few of us know much offhand about our community's hospitals or what they're good at.

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