The state of quality reports: comparing states by their rankings.
BACKGROUND
Public reports ranking physician competence and quality often yield conflicting results and create confusion.


METHODS
Bivariate Pearson correlation analyses were performed to compare states' rankings of physician discipline and physician quality, as reported by the Medicare program and National Practitioner Data Bank. Medical boards were surveyed on their rates of complaints against physicians and ratio of actions to complaints.


RESULTS
For all states, there was a poor to negative correlation between state rankings of disciplinary rates and quality, as well as rates of complaints against physicians. As an example, Wisconsin ranked 50th out of the 50 states plus the District of Columbia (where 1 is most desirable and 51 is worst) in rates of "serious" licensure sanctions, but did well when ranked by Medicare quality (eighth out of 51) and the rate of NPDB adverse reports (second out of 51). Wisconsin had a low rate of complaints per physician, ranking second out of 35 responding states, and a high ratio of actions to complaints, ranking fourth out of 35.


CONCLUSIONS
Conflicting conclusions among public reports on physician discipline and quality raise questions about their methods and validity. State rankings of physician discipline and quality should be viewed with caution.
Roberts
Richard G
RG
Department of Family Medicine, University of Wisconsin School of Medicine and Public Health , Madison 53715, USA. richard.roberts@fammed.wisc.edu
Friedsam
Donna
D
Beasley
John W
JW
Helstad
Cindy
C
Moberg
D Paul
DP
D003627:Data Interpretation, Statistical; D006801:Humans; D010818:Practice Patterns, Physicians' / Q000592:standards*; D019984:Quality Indicators, Health Care; D014481:United States; D014922:Wisconsin