Physician resistance to public reporting of their quality performance scores remains high and will be a continuing obstacle to health care transparency and reform. (see my earlier post). Lawrence Casalino (University of Chicago) and colleagues reported in the most recent issue of Health Affairs (subscription required) on their survey of 556 general internists from across the country about pay for performance and public reporting of quality scores. They indicated that “although a large majority of respondents supported financial incentives for quality, a large majority opposed public reporting, especially reporting of individual physicians’ performance.” More specifically, only one third supported public reporting of individual quality scores while slightly more (45 percent) supported public reporting at the medical group level.
While they can’t explain this resistance, the researchers speculate that “it is possible that respondents believed they were unlikely to lose much from having financial incentives for quality but feared that a poor public quality rating would be humiliating and might lead to losses of patients and of peer approval.” No kidding. And yet this sentiment describes exactly the motivational forces that policy wonks believe will drive the future of quality improvement in health care.
Note to my internists friends: Sure there are probably reasons upon reasons to question current quality measures. But come on guys, fundamentally you got to get on board with this. The demand for transparency is not going to go away. Get over it.
