The Unreliability of Individual Physician 'Report Cards' for Assessing the Costs and Quality of Care of a Chronic Disease

Physician report cards may be unable to detect differences in physician practice and may encourage doctors to "cheat". Researchers determined the reliability of physician report cards covering diabetes care in a large HMO, a university teaching clinic and a private practice group. The study covered 232 doctors and 3,642 patients with type 2 diabetes. Doctors would need to have more than 100 diabetic patients to make the report card a reliable indicator, whereas most had fewer than 60. Doctors could improve their profile by refusing to treat patients who have poor control of their blood sugar.