Objective Numbers, Collected by the Federal Government, on Doctors and Other Health Workers
This page helps you find doctors and nurse practitioners who spend more time with each patient. More time has 3 benefits: They listen and examine you in more detail. They've listened and examined other patients in more detail, so they've learned about diseases in more depth and breadth than at medical school. They can minimize their own burnout, which affects half of doctors in internal medicine, family medicine, and ob/gyn.
Later, when you know specific treatments you need, you can use a different page to see which specialists have the most experience with each procedure.
Maps give a quick look:
You can call any doctor's office to see which hospital and nursing home they visit. You can also check patient reviews, malpractice, etc. as discussed in STEP C of the specialists page. Maps 1 and 3 include Family and General Practice, Geriatric and Internal Medicine, Nurse Practitioners and Physician Assistants, but they omit Ob-gyn, since Ob-gyn data don't show place of treatment.
Lists of doctors, nurse practitioners and physician assistants:
Spreadsheets list all the doctors. Choose the USA (SLOW ! 142 megabytes; save it so you don't have to download it again), or Maryland, DC and nearby Virginia (4 megabytes). They show you:
To find doctors near you, in a specialty, and/or male/female, you can filter the spreadsheets (click an arrow in 3rd row). For example column G shows the state:
Length of office appointments is based on the typical face-to-face time. Hospital and nursing home visits include both face-to-face time, and time dealing with that patient's needs on the hospital floor or at the nursing home (as explained on p.18 of a presentation). The median hospital doctor claims to spend 16 minutes with each patient. Some audiovisual telehealth contact is also covered (p.31 of the same presentation). Time talking to the family with the patient not present is not covered. Length of appointments at home and in assisted living seems to be face-to-face time.
Medicare will pay for more tele-medicine in 2019. Medicare's "telehealth" has been restricted to non-metropolitan areas by 42 U.S. Code § 1395m(m)(4)(C)(i), also called 1834(m), but Medicare is defining "communication technology–based services" to pay $14 for short interactions anywhere, while cutting pay for office visits to keep the overall budget the same.
You can select male or female, but some specialties have few women.
Continuity of Care
The spreadsheets also help you find local doctors who give continuity of care by treating their patients in all 3 settings: office, hospital, and nursing home. If you've been hospitalized, you know the difficulty coordinating between your personal doctor and hospital doctors. Life is easier and care may be better if your personal doctor can treat you in the hospital.
A 2017 study shows that hospital patients where the hospital let their personal doctor treat them, had a better survival rate (91.4%) than patients treated by hospitalists (89.2%). The extra 2.2 percentage points mean that for every 45 hospital patients treated by their personal doctor, one more person was alive 30 days after the hospital stay. The map and spreadsheets (USA or DC area) show which doctors and nurse practitioners do treat patients both in and out of hospitals:
A 2017 JAMA article says, "In an ideal world, primary care physicians would follow their patients from the office to the hospital and to the nursing home. This would improve continuity of care and increase the chances that the patients’ preferences, generally better known by the primary care clinician than a new clinician, are respected..."
On the other hand you can also see the much bigger numbers of providers who specialize and just provide hospital care, office care or nursing home care.
How Many Primary Care Visits in Hospitals and Nursing Homes and Who Does Them?
Primary care doctors in hospitals and nursing homes provide basic ongoing care, in addition to specialists and surgeons who provide their specialties. Some hospitals use their own staff "hospitalists" to provide primary care.
Primary care billing in hospitals (among 49 million Medicare visits billed in 2015):
Many physicians have offices close to a hospital, and some devote a day each week to one nursing home, so patients who choose that hospital and nursing home can see their personal doctor if the institution allows.
These percents include Family and General Practice, Geriatric and Internal Medicine.
Other Sources on Doctors
The spreadsheets have a web link for each doctor, to copy into your browser. It takes you to a consumer rating site, which also takes you to the doctor's website if they can find it. There are helpful hints for using large spreadsheets like this.
You can supplement these bare numbers with all the sources on patient reviews, malpractice, etc. discussed in STEP C of the specialists page.
Some patients want to know who is independent of the hospitals and Accountable Care Organizations (ACOs) which have been absorbing most practices, so they can have independent advice. Lists of doctors who are independent of the major health systems are at: aid-us.org/directory, Idaho, Georgia, New York City, Minneapolis-St. Paul, south Charlotte, . Some groups with "independent" in the name are ACOs with incentives to refer to each other. Insurers also pay incentives to doctors to meet financial goals.
Home Visits: Medicare and other insurance plans pay for home visits when there is a reason, such as letting the doctor assess the home situation, coordinating with home caregivers, or difficulty getting to the office. A doctor describes the emotional benefits he gets from even doing a few home visits per week. Doctors are paid more for home visits than office visits, so copays may be higher too. The spreadsheets described above show names and locations of 4,000 US doctors who do more than 2 home visits for Medicare per week (104/year), so you can find one near you. 1,300 of these doctors do more than 10 home visits per week (520/year). An association of doctors advocates for the service, and also has a referral list of about 300 doctors and groups. There are some experimental programs to save money by deterring seriously ill patients from going to hospitals.
Source: The spreadsheets use Medicare data. They are useful for non-Medicare patients too, since they show differences among doctors even if you are young or privately insured. Doctors who work only for managed care plans, like Kaiser or Medicare Advantage (Part C), are not included, so you will need to look elsewhere. Medicare does not release counts of 10 or fewer patients, to protect privacy, so there is little data on doctors who see few Medicare patients. Address cleaning provided by Texas A&M University GeoServices
Earlier spreadsheets showed:
The first column has an overall rank you can adapt. It looks for the highest values on 5 items:
More Information in the Spreadsheets
The spreadsheet shows
Besides averages, the 2013 spreadsheets show the number of visits by length: 10 minutes, 30 minutes, 60 minutes, etc. Medicare does not estimate time for the annual wellness visit, so I estimated the time based on what they pay, compared to what they pay for regular visits of 25, 40 or 60 minutes. These estimates are 48 minutes for an initial wellness visit and 29 minutes for a subsequent one, and appear separately in the spreadsheet, so you can use other estimates if you wish. There are also physical exams in the first 12 months of Medicare enrollment, which are grouped with the initial wellness exams at 48 minutes. ProPublica shows graphs of how many subsequent appointments at each length each doctor gave in 2012, though one cannot search for doctors who give long appointments. They consider long appointments a cost problem, not a patient benefit.
Each column in the spreadsheet summarizes several billing categories. A summary page lists all the detailed categories, how common each is, national average costs, and Medicare's estimate of how long it takes.
Types of Medicare Patients Seen by Each Doctor
In October 2015, Medicare released information on types of Medicare patients seen by each doctor, to show which doctors are most familiar with these types of patients. The information can be added to the doctor files, but would make the files even bigger. A private insurance app suggests that some patients do want to find doctors who treat patients who are similar by age and gender. Comments are welcome below.
Patient age is calculated at the end of the calendar year or at the time of death.
Race is based an algorithm that uses Census surname lists and geography to improve the accuracy of race/ethnicity classification, particularly for those who are Hispanic or Asian/Pacific Islanders.
Number who had Medicaid sometime in the year
Conditions (based on algorithms used at http://ccwdata.org/index.php)
To protect the privacy of Medicare beneficiaries, the number of beneficiaries fewer than 11 have been suppressed and the percent of beneficiaries between 75% and 100% have been top-coded at 75% .