While much conversation at Medicine X focused around the doctor-patient relationship, ProPublica reporter Charles Ornstein posed to conference attendees this morning a more fundamental question: How do you find a doctor? "This is trickier than you think," he said and proceeded to discuss how data can yield helpful information for those looking for (or assessing their current) physician. He outlined some of the information - mostly involving doctor-industry relationships and physician-prescribing practices - that ProPublica has gleaned from federal databases, and he outlined questions that patients might want to ask their doctors about such things. ("So my doctor has a relationship with a company. But how is that affecting my care?” he said.)
Ornstein spent a good amount of time discussing the importance of making information - presumably not just information on negative things, such as whether a doctor appears to over-prescribe a certain medication or has ever been disciplined, but also about thoughts on physicians' care from patients - more widely available.“We all want doctors who are good at what they’re doing clinically, and it’s time for us to stop making that a secret," he said, before making his closing statement that “Data should be freed so we can make better health-care decisions.”
In the panel session - moderated by our own Paul Costello - that followed, several important points were made. First, Vivian Lee, MD, PhD, MBA, dean of the University of Utah School of Medicine and CEO of University of Utah Health Care, reminded the audience that the "majority of doctors are not bad apples" and can improve on things if given the chance. University of Utah makes patient-survey information publicly available, and she described the six-month period before this service was launched as a time where doctors worked to boost their level of care. Almost every doctor received at least 4 out of 5 stars by the time the rankings went online, she said.
Panelist Carly Medosch, a patient advocate who has had Crohn's disease for 20 years, expressed support for access to physician data but pointed out that she doesn't have time to dig through "tons and tons of research" - she not only has a regular job but a second job managing her disease. And "If I'm taken to the ER for a ruptured intestine I don’t have time to ask questions" about, for example, a doctor's industry relationships, she pointed out. It was an important reminder that access to data alone might not greatly benefit the average chronically ill patient.
Towards the end of the session, the panelists shared their own ideas of what makes a good doctor, with Ornstein listing good clinical outcomes and empathy as two must-haves. Numerous attendees took to Twitter to express their own thoughts, including patient advocate Liza Bernstein, who offered at least 10 criteria. (My personal favorite: "What kind of PERSON are you? Yes, always, top of your field, but are you a #mensch?) Given the complexity of the issue, as outlined during the panel, I think this attendee hit the nail on the head by tweeting:
What makes a good doctor? Medicine is not a monolith. There is no simple, single answer, regardless of data availability.
More news about Stanford Medicine X is available in the Medicine X category.
Previously: Medicine X aims to “fill the gaps” in medical education, Relationships the theme of the day at Stanford’s Medicine X, Stanford Medicine X 2014 kicks off today and Medicine X spotlights mental health, medical team of the future and the “no-smartphone” patient
Photo of Ornstein (far right) and panelists by Stanford Medicine X