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The dos (and don'ts) of picking a doctor

September 13, 2010

Choosing a new physician can be a daunting task. That doctor will know your medical history and aid you when you're ill – perhaps even catch life-threatening illnesses before they get out of control. It’s a pretty important (and ideally, a long-term) relationship.

But there isn’t a wealth of information out there helping people to choose that special doctor. Thus, patients may rely on what appear to be good indicators of performance – how many years of experience the doctor has, or whether he or she has been sued by a patient for malpractice, for example.

But, says a new study published Monday in the Archives of Internal Medicine, those patients may be making that decision based on the wrong criteria.

Take, for example, experience. More experience equals better doctor, right? Perhaps not. "Studies have found an inverse relationship between years of experience and performance on quality measures,"  the paper's authors wrote.

These researchers from the University of Pittsburgh and RAND Corp. rated doctors using 124 indicators of quality of care for 22 acute and chronic conditions. Based on those metrics, they determined some possible indicators of physician quality: being female, being board certified and graduating from a domestic school.

And yet, there's a measly 5.9% gap between those doctors with the best characteristics and those with the worst. So ultimately, even the factors that can be pinpointed don't make for a huge difference in quality.

(By the way, the malpractice claims against a physician had little to do with how good that doctor is, the authors said.)

"In conclusion, we found that individual physician characteristics are poor proxies for performance on clinical quality measure and are not well suited for use as such by patients," the authors wrote.

So what's a patient to do? Leave it to luck? Probably not. Until more information about physicians' performance is publicly available, perhaps the best lesson to take from this study is not to make assumptions about doctors because of, say, their diploma or their years on the job.

In the meantime, for those looking for a little how-to on researching doctors, the U.S. Department of Health and Human Services provides a handy starting point.

-- Amina Khan / Los Angeles Times

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