AMA: Do it, but do it right
December 1, 1997 2 minutes read
AMA: Do it, but do it right
Group sets physician profiling standards
It seems that even the American Medical Assoc-iation has accepted the place of physician profiling in a managed care environment. The Chicago-based AMA has published 11 principles of profiling it suggests managed care entities adopt. Below are the guidelines, which are part of the AMA’s new physician accreditation program. (For more on the American Medical Accreditation Program and its standards, see Physician’s Managed Care Report, October 1997, pp. 135-136).
1. The active involvement of physician organizations and practicing physicians in all aspects of physician profiling shall be essential.
2. The methods for collecting and analyzing data and developing physician profiles shall be disclosed to relevant physician organizations and physicians under review.
3. Valid data collection and profiling methodologies, including establishment of a statistically significant sample size, shall be developed.
4. The limitations of the data sources used to develop physician profiles shall be clearly identified and acknowledged.
5. Physician profiles shall be based on valid, accurate and objective data and used primarily for educational purposes.
6. To the greatest extent possible, physician profiling initiatives shall use standards-based norms derived from widely accepted, physician-developed practice parameters.
7. Comparisons among physician profiles shall adjust for patient case mix, control for physician specialty, and distinguish between the ordering or referring physician and the physician providing the service or procedure.
8. The quality and accuracy of physician profiles, data sources and methodologies shall be evaluated regularly.
9. Physician profiling data and any other information that has been compiled related to physician performance shall be shared with physicians under review.
10. Effective safeguards to protect against the unauthorized use or disclosure of physician profiles shall be developed.
11. Any disclosure or release of physician profiles shall follow strict conformance to the AMA’s "Principles to Guide the Collection, Release and Use of Physician-Specific Health Care Data."
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