Fine-tuning measurements of doctors’ performance

Regarding “Rethinking criteria for doctors’ pay” (March 15):

As physicians work to improve the quality of healthcare for patients, pay for performance is one of the newest trends sweeping the healthcare industry.

Doctors are eager to learn and improve and want to ensure that any insurer’s evaluation is truly in the patients’ best interest.

Through the American Medical Assn.-convened Physician Consortium for Performance Improvement, more than 170 physician performance measures have been developed for asthma, heart failure and emergency care, just to name a few.

Many of the measures have been endorsed by an independent quality organization, and we encourage their widespread use by physicians and health plans, though it is crucial that the assessment accurately reflect the quality of care provided.

For example, a performance measure may call on physicians to prescribe a statin drug for patients with heart disease, yet the physician might be reviewed through insurance claims data that show only if a patient filled the prescription.

A new survey found that a quarter of Americans say they did not fill a prescription because they felt it was unneeded -- many more aren’t filled for other reasons not surveyed.

If quality measures and ratings are not properly used and aligned, we run the risk of losing the promise of a program that might improve healthcare quality.

Cecil Wilson, MD

Board Chair

American Medical Assn.

Chicago