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Links to the Topics on this Site
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Checkup Sites for Specialists:
Docs' Experience+Cost: East+West (150 Mbytes, Codes) Reviews by doctors $, or editors: Castle $, Super Reviews by patients: Angies $, RateMDs, Vitals Federal lawsuits $ State licenses, training, some malpractice Phone, address, hospitals, medical school, languages Phone, address (national search: city+state not needed) Payments from drug+device companies 2013 Payments from drug companies 2009-13 Drugs s/he prescribes. Evaluation of drugs Compare billings with state average Hospital cost: list, map Best treatment methods: UpToDate $ Search for over-used procedures |
How Can Primary Care Doctors and Patients Find the Most Experienced Specialists?
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There are many groups which list specialized doctors and centers, to help patients find doctors with experience: Bone Marrow Transplants National Cancer Institute Cystic Fibrosis, see counts at each center by registering National Lymphedema Network National Multiple Sclerosis Society Muscular Dystrophy Association Neurofibromatosis, Children's Tumor Foundation Post-Polio Health International Sickle Cell Disease, Centers for Disease Control Spina Bifida Association Tourette Syndrome Association Transplant Centers, Medicare To Find Highly Experienced Doctors, Start Here2013 Specialist Doctors
The main file has 775,000 records on 230,000 providers in 130 megabytes. A sample file has 4 megabytes with all the data for Zip codes 20000 to 22599 (DC, MD, nearby VA).
For each provider, there's a separate record for each medical procedure done at least 11 times on Medicare patients in 2013. The record shows how often the provider did the procedure and average cost, along with the provider's address and a web link. Click to download it, then save it so you don't need to wait for another download. After you open it, to find the specialists in an area:
When "Procedure Descriptions" are unclear to you, click them in the list, then look up the Number and Description on the web. For example if you want someone experienced with broken wrists, you'll start with the Category "bone+muscl-wrist." Then these Procedure Descriptions seem relevant: "25320 Repair of wrist joint" and "25605 Treatment of broken or growth plate separate of forearm bone at wrist". The first is pretty clear, but searching the second on the web shows it can refer to growing bones in children or fractures in the distal [far end] radial [radius bone in lower arm], so that's in the wrist area too, and the file shows it is more common than breaks in the wrist itself. A list shows national totals for each procedure: number of doctors, number of procedures and average cost, so that may be a good place to search for the most common codes in the categories you need. The file shows the average cost for Medicare patients and the list price. Your insurance may differ, and uninsured patients can try to negotiate somewhere between these. Separately, the file shows the average length and cost of appointments, if you need a consultation. Unlike most medical sites, your searches are private, since you're searching the spreadsheet on your own computer 2012 Specialist Doctors
Labels in the spreadsheet are not as clear in 2012 as in 2013, but codes are the same, so if you want to find high volume doctors in 2012, you can look for appropriate codes among the 2013 doctors, or the 2013 list, or a 2012 List. For example if you have knee problems, you can:
You can write down the names or codes of procedures which interest you, and look for those in the 200, East or West files (links below) to find doctors who do them and can advise you. The spreadsheet cannot advise you; it can only help you find doctors with experience. Continuing the knee example, the list shows that Orthopedic Surgeons do most knee procedures. If you want to compare what Rheumatology or Pain Management specialists can do, you can:
The detailed spreadsheets let you find highly experienced doctors doing each procedure, in your region of the country (2-digit zip code), and the least experienced. After you find some, you can check them in other ways, as discussed on the bottom of this web page.
The files show the doctors' names and addresses. Their phone numbers are in another Medicare file. Description of the Spreadsheets You have two ways to explore the entire country: (A) with File 1, the highest-volume doctors for each procedure, OR (B) Files 2 and 3, East and West, with the far larger number of doctors who did procedures 11 or more times in 2012. All files include nurse practitioners and certified nurse anesthetists (CRNA), who often work quite independently. The files include all specialties except Labs, Ambulance crews, Physician Assistants and Anesthesiology Assistants. These assistants work under an anesthesiologist's direction, so most people will search for the experienced doctor, not the assistant. The spreadsheets exclude the commonest procedures, like chest X-rays, basic office visits and injections. Most providers who do those do so many that comparing their experience is unnecessary, and people need to choose on other grounds, discussed below. The spreadsheets also exclude procedures costing less than $52, in order to omit many marginally significant procedures and keep the overall data in just 2 files, covering the East and West of the country. The cutoff is arbitrary, but most people will search for doctors primarily for major procedures rather than minor, inexpensive procedures. Besides average costs, files 1-3 also show standard deviations of cost for each doctor and procedure, so you can see how much variation there is. About a third of patients are within one standard deviation above the average cost, and another third are within a standard deviation below the average. Only a sixth have costs above that range, and another sixth are below the range. Many Medicare costs have small standard deviations, where every doctor gets about the same payment per procedure, with slight variations for extra complexity. Source of Data The files are extracted from the Medicare fee-for-service program. They include doctors and other medical professionals who did any procedure 11 or more times on Medicare patients in Jan-Dec 2012. They don't reflect other years, treatment of younger people, or Medicare HMOs. Patients can ask doctors' offices how much they treat younger people or HMOs. Occasionally a provider code covers several doctors, and it always covers the residents and fellows training under the named doctor, if any. The doctor's website usually says if a doctor teaches, or patients can ask the doctor's office. The website also names any colleagues, and patients can see if these have their own unique provider codes in either the East and West files or the telephone file, which includes all Medicare doctors, not just those with 11 or more procedures. 650 of the 2 million records had inconsistencies between 2-digit zip code and state. When state needed to be corrected, it was put in lower case. When zip was corrected, one letter of the state code was made lower case. These corrections put doctors in the correct areas for searching, but errors may remain in other fields, probably at the same error rate of one per 3,000. |
A patient at Shouldice told me that his wife wants to specialize in breast surgery, as the Shouldice doctors specialize in hernias. She has enough patients, but other surgeons at her hospital resist, since they want her to share on-call duties with the other general surgeons. She hasn't been able to specialize, but elsewhere some surgeons do specialize in breast surgery and perform 100 or so per year. Patients and referring doctors can find them in the spreadsheets here.
When more referring doctors and patients search for high-volume specialists, more doctors will be able to become high-volume and highly experienced in their specialties.
Professors
Professors often are high-volume doctors, since all patient care they supervise counts as theirs, even when it was done by interns and residents.
Many people want to be treated by medical school professors, to get cutting edge researchers and freshly trained residents. Other people worry about residents practicing on them, and surgical professors who are out of practice since residents do most of their operations.
Two reports describe residents doing most of the cutting and stitching when they are in the operating room.
Dr Gawande when he was a resident wrote that "to say I just assisted remains a kind of subterfuge... I hold the knife... I stand on the operator's side of the table... raised to my six-feet-plus height... Given the stakes, who in their right mind would agree to be practiced upon?" (pp. 22, 30) There is other research on the benefits of simulators and dangers of undertrained doctors, both young and old.
A study of surgeries in Veterans Administration hospitals reported "We believe in the majority of open repairs, that the resident was on the side of the hernia, and presumably was the person making the cut and putting the stitches in" (p. 352). The VA hernia study found more recurrences after open operations done by interns and 2nd year residents (6.4% recurrence), than by 4th year or older residents (1.1%). 3rd year residents were in the middle at 3.0%. Recurrences in laparoscopic hernia repairs were about 11%, regardless of the resident's year. "Only when the attending surgeon and the resident are highly experienced in laparoscopic repair techniques, are recurrence rates for laparoscopic repairs reduced" (p. 882).
A study of bypass procedures found that patients of medical school professors had the worst death rates, and explained it may have been "because more of their operations are performed by residents or fellows" (p. 93).
Surgery at teaching hospitals usually involves residents. Patients who value a teaching hospital appreciate the presence of the professor directing the work, even if a resident does the cutting. Patients who doubt the residents may need to go elsewhere, though they can ask if the professor will operate without a resident, and cross out words allowing residents or substitute surgeons from the consent form. When residents examine a patient in an office or hospital, the patient can ask the main "attending" doctor to do the exam, but the main doctor may prefer to depend on residents. For office consultations, residents and fellows are often present, but patients can focus on the main doctor's questions and decisions.
When more referring doctors and patients search for high-volume specialists, more doctors will be able to become high-volume and highly experienced in their specialties.
Professors
Professors often are high-volume doctors, since all patient care they supervise counts as theirs, even when it was done by interns and residents.
Many people want to be treated by medical school professors, to get cutting edge researchers and freshly trained residents. Other people worry about residents practicing on them, and surgical professors who are out of practice since residents do most of their operations.
Two reports describe residents doing most of the cutting and stitching when they are in the operating room.
Dr Gawande when he was a resident wrote that "to say I just assisted remains a kind of subterfuge... I hold the knife... I stand on the operator's side of the table... raised to my six-feet-plus height... Given the stakes, who in their right mind would agree to be practiced upon?" (pp. 22, 30) There is other research on the benefits of simulators and dangers of undertrained doctors, both young and old.
A study of surgeries in Veterans Administration hospitals reported "We believe in the majority of open repairs, that the resident was on the side of the hernia, and presumably was the person making the cut and putting the stitches in" (p. 352). The VA hernia study found more recurrences after open operations done by interns and 2nd year residents (6.4% recurrence), than by 4th year or older residents (1.1%). 3rd year residents were in the middle at 3.0%. Recurrences in laparoscopic hernia repairs were about 11%, regardless of the resident's year. "Only when the attending surgeon and the resident are highly experienced in laparoscopic repair techniques, are recurrence rates for laparoscopic repairs reduced" (p. 882).
A study of bypass procedures found that patients of medical school professors had the worst death rates, and explained it may have been "because more of their operations are performed by residents or fellows" (p. 93).
Surgery at teaching hospitals usually involves residents. Patients who value a teaching hospital appreciate the presence of the professor directing the work, even if a resident does the cutting. Patients who doubt the residents may need to go elsewhere, though they can ask if the professor will operate without a resident, and cross out words allowing residents or substitute surgeons from the consent form. When residents examine a patient in an office or hospital, the patient can ask the main "attending" doctor to do the exam, but the main doctor may prefer to depend on residents. For office consultations, residents and fellows are often present, but patients can focus on the main doctor's questions and decisions.
On Your Knees
Many people know someone who has had a knee replacement. The medical term is "Total knee arthroplasty." The UpToDate article on it starts by referring readers to medical management of rheumatoid arthritis, and also cites a range of surgical options. The next paragraphs discuss knee replacement, because it is well-known, not because replacement is the first choice.
The 200 file (described in the Box above) shows that the 20 highest volume Medicare providers are spread all over the country, in 13 states: Alabama, Arkansas, California, Colorado, Florida, Georgia, Illinois, Missouri, New Jersey, Oklahoma, South Carolina, Tennessee, and Texas.
The websites of these high-volume doctors are worth exploring. If one of them accepts your insurance and you live nearby or have friends where you can stay during the long recuperation, you can consider going to them.
Dr Bassett in Harlingen Texas has the highest volume with 434 knee replacements. His website has a variety of information from Biomet (which makes joints). His website also says he teaches at the U of Texas, so many of his surgeries are likely done by residents. Dr Dearborn in Fremont California is second with 411 knee replacements. His web page does not say that he teaches; it does have a 10-page pdf description of alternative ways to do the operation and some of its risks.
Wherever you live you can also look closer to home. For example in the Washington DC region, Dr Dalury north of Baltimore did 211 knee replacements. If he is too far and you can accept doctors who do 2 per week instead of 4-8 per week, you can look in the immediate area around Washington (zip codes beginning with 20). The East file shows the largest practices are Dr Cannova in Bethesda MD with 120 knee replacements, or Dr Peyton in Sterling VA with 88. These doctors' websites say if they teach and why they recommend certain brands of knee joint. When patients see a doctor they can ask about the brands and approaches they have found on other doctors' sites.
Medicare and ProPublica tell you what payments each doctor received from medical companies. Biomet paid Dr Peyton $46,000 in royalties, so he may be quite expert on Biomet's joint. Patients need to decide if relationships with medical companies will strengthen or weaken their care. DocFinder and Pacer are ways to search for legal actions against any doctor you consider.
Your correspondent does not know or have any relation with any of these named doctors, and has been fortunate not to need a knee replacement, so there is no personal knowledge or bias here.
Each patient or referring doctor can similarly search for Pain Management, Rheumatology and other specialties to find alternatives, and then decide whether local or distant doctors will work out better.
Medical Costs
Besides experience, the spreadsheets show averages of Medicare costs, and they show the list price for each procedure from each provider. Medicare costs include the total paid by Medicare, supplemental insurance and patients.
Each patient's cost depends on his or her insurance. For those without insurance, the Medicare level is a starting point for negotiation. In order to know total costs, patients can ask the doctor's office whether an anesthesiologist, assistant surgeon or hospital fee will be needed. Anesthesiologist costs are in the doctor spreadsheets above. Hospital costs for the most common 100 diagnoses are in hospital spreadsheets from Medicare, and are mapped nicely at ClearHealthCosts.
For example surgeon costs for knee replacement are typically around $1,500, assistant surgeon $300, anesthesiologist $200, and hospital costs (for "major joint replacement or reattachment of lower extremity") averaged $14,000 if there were no major comorbidities and complications (MCC), or $23,000 if there were.
Other Information for Choosing Doctors
As mentioned above, Dr Kussin's book (Dr, Your Patient Will See You Now) suggests almost always getting a 2nd opinion, and getting it from another specialty (p. 184). He also recommends using foreign doctors, since it took brains to cross all the hurdles to practice in the US (p. 135), and he suggests using doctors who trained at top hospitals, since it took brains to get in (p. 131). A study of bypass operations showed no difference in death rates between doctors trained at top hospitals and others (Hartz et al), but brains are also important in deciding who needs an operation.
Doctors who refer many patients to a particular specialist could check them in some of the ways listed below, and even compile fact sheets, but don't have time to check all specialists.
Patients can use published surveys to find doctors recommended by other doctors. Many cities have local surveys, called "Top Docs," "Best Docs," or "Superdocs." Nationally, Consumer Checkbook surveyed 375,000 doctors in 2009 in 53 metro areas ($25 online, $1 used). They list 24,000 doctors who received the most recommendations, and show the number of recommendations each received. Their research says that in general these doctors also:
A 1999 study found that doctors were more likely to be in such lists "if they trained in prestigious residencies (P<0.01) or fellowships (P<0.05), or if they had an academic appointment (P<0.05) or 15 or more years of experience (P<0.001)."
Consumer reviews tell if a doctor speaks clearly and listens. Dr Wen of George Washington U and Dr Kosowsky of Harvard say doctors need to communicate well with patients to get information for a good diagnosis. "Choose someone who makes time to listen to you and answer your questions... and who engages you in a discussion of your diagnosis. By the same token, watch out for doctors who display signs of impatience, intolerance, condescension, or inflexibility" (p. 211). Their book goes on to describe in detail how patients need to prepare before seeing a doctor. At this writing, AngiesList, RateMDs, Vitals, Wellness and Yelp show written reviews, HealthGrades, LifeScript and UCompareHealth show votes but few or no written reviews. Most allow one review or vote per email address, so the ballot box can be stuffed. Stuffing AngiesList would be expensive, since it costs money to subscribe; it offers a national subscription which lets patients check doctors far and near. The 5 knee doctors named above have 3-11 reviews each; your mileage will vary.
Patients can see what payments doctors get from medical companies (Medicare's site) and drug companies (ProPublica's site). It is not surprising when high-volume doctors receive payments from companies for various purposes. Patients need to decide if these affect their care.
Patients can see what drugs the doctors often prescribe (click on "Prescriber Checkup"), and get independent reviews of those drugs from the Public Citizen Health Research site, WorstPills.org ($15/year), or less detailed reviews from Consumer Reports Drugs (free).
Patients can see how the doctor's overall practice compares to other doctors in the same specialty and state (ProPublica's site). For example Dr Bassett in Texas performs more knee X-rays and repairs than average, since knees are his specialty.
DocFinder has a free search of 17 states, and links to the other state boards for the few disciplinary actions against doctors. Some states only divulge current suspensions, not past suspensions. DocInfo has a national search for $10 per doctor and another list of state medical boards. There is a lag before state data are posted in the central files. The same searches verify if a doctor's license is up to date.
Medicare shows affiliations to hospitals and medical groups, languages, phone numbers and addresses of each location of a doctor. For that search you need to know the doctor's zip code or city and state; another file allows a national search by name only.
Some people want to know success rates of individual doctors, but success rates are controversial, since they encourage doctors to avoid risky patients, have unreliably small samples, and are hard to find anyway.
Most commercial sites use cookies, login, and/or IP address to track the webpages patients go to and sell the information to data brokers, revealing what diseases they're researching. Globe1234 does not (Privacy Policy), and when you download a spreadsheet, you search it on your own computer, so Globe1234 cannot know what diseases you researched.
Legal Actions
Some state boards provide information on malpractice suits in the DocFinder lists above, but usually patients have to search the web or state court records. Each state has its own system for searching.
Federal court records (such as Medicare fraud) are easily searchable at Pacer (10 cents/page. $2.40 per audio file of court hearings). Even malpractice cases can appear in federal court when patients and medical suppliers are in different states. The doctors indicted by Medicare's fraud team appear in Pacer. The highest-volume surgeon for knee replacements is in Pacer as a co-defendant in one federal case in 2014, which became part of a settlement agreement. Patients can ask for information and decide if it matters to them. The weight loss surgeons reported by the LA Times are in Pacer because of a 2012 whistleblower suit and a suit by the same surgeons against a health insurer. Of two doctors named in the NY Times article on heart surgery, one is in Pacer since he sued the hospital for suspending him; the other is not. The spine surgeon reported by the Washington Post does not appear in Pacer, since the whistleblower suit was filed against the hospital. The three surgeons named by USA Today all appear in Pacer.
Thus Pacer provides a lot of information, though not a complete list of problems. There is a far more complete list of problem doctors which Congress does not want you to see. The Practitioner Data Bank lists "800,000 license and hospital disciplinary reports and past malpractice payment reports for clinicians" 1990-2014. Congress forbids showing the list to patients or referring doctors. The federal government shows the list to those it thinks "need to know the most - the hospitals that are considering hiring [doctors] or the licensing board." There is a public version without names and addresses if you agree to their Data Use Agreement. The size of the list ranges from 900 adverse actions in Hawaii to 50,000 in Texas over the last decade. Several reporters have used the list for stories.
Data on doctors' quality are still limited, but the data provided here on doctors' volume are helpful in the absence of direct quality data. As quoted at the beginning of the article, researchers in the field recommend choosing high-volume doctors when possible.
Many people know someone who has had a knee replacement. The medical term is "Total knee arthroplasty." The UpToDate article on it starts by referring readers to medical management of rheumatoid arthritis, and also cites a range of surgical options. The next paragraphs discuss knee replacement, because it is well-known, not because replacement is the first choice.
The 200 file (described in the Box above) shows that the 20 highest volume Medicare providers are spread all over the country, in 13 states: Alabama, Arkansas, California, Colorado, Florida, Georgia, Illinois, Missouri, New Jersey, Oklahoma, South Carolina, Tennessee, and Texas.
The websites of these high-volume doctors are worth exploring. If one of them accepts your insurance and you live nearby or have friends where you can stay during the long recuperation, you can consider going to them.
Dr Bassett in Harlingen Texas has the highest volume with 434 knee replacements. His website has a variety of information from Biomet (which makes joints). His website also says he teaches at the U of Texas, so many of his surgeries are likely done by residents. Dr Dearborn in Fremont California is second with 411 knee replacements. His web page does not say that he teaches; it does have a 10-page pdf description of alternative ways to do the operation and some of its risks.
Wherever you live you can also look closer to home. For example in the Washington DC region, Dr Dalury north of Baltimore did 211 knee replacements. If he is too far and you can accept doctors who do 2 per week instead of 4-8 per week, you can look in the immediate area around Washington (zip codes beginning with 20). The East file shows the largest practices are Dr Cannova in Bethesda MD with 120 knee replacements, or Dr Peyton in Sterling VA with 88. These doctors' websites say if they teach and why they recommend certain brands of knee joint. When patients see a doctor they can ask about the brands and approaches they have found on other doctors' sites.
Medicare and ProPublica tell you what payments each doctor received from medical companies. Biomet paid Dr Peyton $46,000 in royalties, so he may be quite expert on Biomet's joint. Patients need to decide if relationships with medical companies will strengthen or weaken their care. DocFinder and Pacer are ways to search for legal actions against any doctor you consider.
Your correspondent does not know or have any relation with any of these named doctors, and has been fortunate not to need a knee replacement, so there is no personal knowledge or bias here.
Each patient or referring doctor can similarly search for Pain Management, Rheumatology and other specialties to find alternatives, and then decide whether local or distant doctors will work out better.
Medical Costs
Besides experience, the spreadsheets show averages of Medicare costs, and they show the list price for each procedure from each provider. Medicare costs include the total paid by Medicare, supplemental insurance and patients.
Each patient's cost depends on his or her insurance. For those without insurance, the Medicare level is a starting point for negotiation. In order to know total costs, patients can ask the doctor's office whether an anesthesiologist, assistant surgeon or hospital fee will be needed. Anesthesiologist costs are in the doctor spreadsheets above. Hospital costs for the most common 100 diagnoses are in hospital spreadsheets from Medicare, and are mapped nicely at ClearHealthCosts.
For example surgeon costs for knee replacement are typically around $1,500, assistant surgeon $300, anesthesiologist $200, and hospital costs (for "major joint replacement or reattachment of lower extremity") averaged $14,000 if there were no major comorbidities and complications (MCC), or $23,000 if there were.
Other Information for Choosing Doctors
As mentioned above, Dr Kussin's book (Dr, Your Patient Will See You Now) suggests almost always getting a 2nd opinion, and getting it from another specialty (p. 184). He also recommends using foreign doctors, since it took brains to cross all the hurdles to practice in the US (p. 135), and he suggests using doctors who trained at top hospitals, since it took brains to get in (p. 131). A study of bypass operations showed no difference in death rates between doctors trained at top hospitals and others (Hartz et al), but brains are also important in deciding who needs an operation.
Doctors who refer many patients to a particular specialist could check them in some of the ways listed below, and even compile fact sheets, but don't have time to check all specialists.
Patients can use published surveys to find doctors recommended by other doctors. Many cities have local surveys, called "Top Docs," "Best Docs," or "Superdocs." Nationally, Consumer Checkbook surveyed 375,000 doctors in 2009 in 53 metro areas ($25 online, $1 used). They list 24,000 doctors who received the most recommendations, and show the number of recommendations each received. Their research says that in general these doctors also:
- "Get much higher ratings than other doctors when we survey patients;
- Are much more likely than other doctors to be board certified;
- Are less likely than other doctors to have disciplinary actions filed against them with state medical boards; and
- In the one specialty for which we have good data on outcomes (death rates in cardiac by-pass surgery), have better results."
A 1999 study found that doctors were more likely to be in such lists "if they trained in prestigious residencies (P<0.01) or fellowships (P<0.05), or if they had an academic appointment (P<0.05) or 15 or more years of experience (P<0.001)."
Consumer reviews tell if a doctor speaks clearly and listens. Dr Wen of George Washington U and Dr Kosowsky of Harvard say doctors need to communicate well with patients to get information for a good diagnosis. "Choose someone who makes time to listen to you and answer your questions... and who engages you in a discussion of your diagnosis. By the same token, watch out for doctors who display signs of impatience, intolerance, condescension, or inflexibility" (p. 211). Their book goes on to describe in detail how patients need to prepare before seeing a doctor. At this writing, AngiesList, RateMDs, Vitals, Wellness and Yelp show written reviews, HealthGrades, LifeScript and UCompareHealth show votes but few or no written reviews. Most allow one review or vote per email address, so the ballot box can be stuffed. Stuffing AngiesList would be expensive, since it costs money to subscribe; it offers a national subscription which lets patients check doctors far and near. The 5 knee doctors named above have 3-11 reviews each; your mileage will vary.
Patients can see what payments doctors get from medical companies (Medicare's site) and drug companies (ProPublica's site). It is not surprising when high-volume doctors receive payments from companies for various purposes. Patients need to decide if these affect their care.
Patients can see what drugs the doctors often prescribe (click on "Prescriber Checkup"), and get independent reviews of those drugs from the Public Citizen Health Research site, WorstPills.org ($15/year), or less detailed reviews from Consumer Reports Drugs (free).
Patients can see how the doctor's overall practice compares to other doctors in the same specialty and state (ProPublica's site). For example Dr Bassett in Texas performs more knee X-rays and repairs than average, since knees are his specialty.
DocFinder has a free search of 17 states, and links to the other state boards for the few disciplinary actions against doctors. Some states only divulge current suspensions, not past suspensions. DocInfo has a national search for $10 per doctor and another list of state medical boards. There is a lag before state data are posted in the central files. The same searches verify if a doctor's license is up to date.
Medicare shows affiliations to hospitals and medical groups, languages, phone numbers and addresses of each location of a doctor. For that search you need to know the doctor's zip code or city and state; another file allows a national search by name only.
Some people want to know success rates of individual doctors, but success rates are controversial, since they encourage doctors to avoid risky patients, have unreliably small samples, and are hard to find anyway.
Most commercial sites use cookies, login, and/or IP address to track the webpages patients go to and sell the information to data brokers, revealing what diseases they're researching. Globe1234 does not (Privacy Policy), and when you download a spreadsheet, you search it on your own computer, so Globe1234 cannot know what diseases you researched.
Legal Actions
Some state boards provide information on malpractice suits in the DocFinder lists above, but usually patients have to search the web or state court records. Each state has its own system for searching.
Federal court records (such as Medicare fraud) are easily searchable at Pacer (10 cents/page. $2.40 per audio file of court hearings). Even malpractice cases can appear in federal court when patients and medical suppliers are in different states. The doctors indicted by Medicare's fraud team appear in Pacer. The highest-volume surgeon for knee replacements is in Pacer as a co-defendant in one federal case in 2014, which became part of a settlement agreement. Patients can ask for information and decide if it matters to them. The weight loss surgeons reported by the LA Times are in Pacer because of a 2012 whistleblower suit and a suit by the same surgeons against a health insurer. Of two doctors named in the NY Times article on heart surgery, one is in Pacer since he sued the hospital for suspending him; the other is not. The spine surgeon reported by the Washington Post does not appear in Pacer, since the whistleblower suit was filed against the hospital. The three surgeons named by USA Today all appear in Pacer.
Thus Pacer provides a lot of information, though not a complete list of problems. There is a far more complete list of problem doctors which Congress does not want you to see. The Practitioner Data Bank lists "800,000 license and hospital disciplinary reports and past malpractice payment reports for clinicians" 1990-2014. Congress forbids showing the list to patients or referring doctors. The federal government shows the list to those it thinks "need to know the most - the hospitals that are considering hiring [doctors] or the licensing board." There is a public version without names and addresses if you agree to their Data Use Agreement. The size of the list ranges from 900 adverse actions in Hawaii to 50,000 in Texas over the last decade. Several reporters have used the list for stories.
Data on doctors' quality are still limited, but the data provided here on doctors' volume are helpful in the absence of direct quality data. As quoted at the beginning of the article, researchers in the field recommend choosing high-volume doctors when possible.
