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Thursday, September 5, 2013

Doctors vs Big Data



As we shift from using no data, to bad data, to better data, and ultimately to good data, we need to be fair to doctors regarding where we are.




There is a storm brewing in Healthcare. Doctors have been in charge of healthcare for a long time, and have become comfortable, sometimes even arrogant, with their authority and power. But dumb data beats smart doctors every time. Forward thinking doctors are embracing data, with surprising grace and humility. Others are having much more trouble adjusting.




Doctors, historically, have been the “end of the discussion” on clinical matters. Doctors make the diagnosis, they make the calls in the surgery suite, they get to decide if someone is suffering enough to justify pain medications, they frequently decide whether someone is mentally incompetent or merely eccentric. Our society places a lot of trust in doctors, because they have the training needed to make really hard choices.




Doctors, as a group, have been in charge of how healthcare operates for centuries. In times past, the only way to determine whether a doctor was doing a good job was to become a doctor yourself, and then perform case reviews. Even in court, if you wanted to refute a doctor, you needed another doctor.




But that time has changed. Now we have data on doctors. We have data on how they work together, on how they prescribe. We can tell whether they wash their hands well enough, and whether they use the right procedures in the right situation. In many ways the culmination of the EHR adoption is really the dawn of doctor science. We can now tell, with a fair amount of objectivity, how good doctors are at their jobs.




But doctors are very resistant to being evaluated in this way, as shown by recent polls done by acpe.org. Many doctors find the notion of subjective patient ratings on various online websites distasteful. This is interesting, since there is some evidence that online rating scores are at least aligned with more traditional, and expensive, patient surveys. Another poll from the same organization showed that doctors were split on whether CMS should release more medical claims data. Apparently, a sizeable contingent of doctors are opposed to being rated and evaluated, no matter whether the data is subjective or objective.




There is a valid reason for doctors to have a dim view on both patient ratings and claims data. Both data sources are biased in different ways.










by Shane Turner via NursingFacultyJobs.com

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