Take Doc Scorecard With Dose of Caution

* “HMO Releases Scorecard on Doctor Groups” [Sept. 1] discussed the release of a quality rankings index by PacifiCare Health Systems Inc. on its medical groups.

The release of such information not only provides a source of reference for consumers in evaluating their health-care providers, it also encourages health-care professionals to constantly improve the quality of their service in order to remain competitive in the market. Thus, it is certainly one way to help maintain a standard in the quality of health care, which has gradually disappeared over time.

However, cautions should be taken when interpreting these rankings. Reliability of the rankings depends on various factors, including how the data was obtained and analyzed and the subjects used.

Furthermore, how one uses the information in order to suit one’s needs is critical as well. One should carefully examine the basis of the rankings before using them. After all, the best-ranked health-care provider on a certain category of rankings may not represent the most proper choice.

SARAH LIAW

Emeryville

* PacifiCare deserves applause for increasing health-care consumers’ decision-making power and for attempting to improve quality of care by creating physician competition. Other health plans should follow suit.

However, caveats are in order. Some doctor groups, such as those with loyal followers or those in rural areas where there are few physicians, may not be concerned about competition from other medical groups. Furthermore, doctor groups that serve disproportionately sick and low-income populations may lack the resources necessary to boost their rankings.

Health plans must supplement scorecards with overall quality standards, continuous evaluation of quality measurement and improvement methods, and assistance to medical groups that are less capable of improving quality given the populations they serve.

MIRIAM HOERETH

Berkeley