Introduction to Physician Profiling

Abstract

The physician profiling has emerged as a kind of report card in the US healthcare industry since the 1990s. It is believed that physician profiling can be regarded as a reliable analytical mean for continuous quality improvement, cost containment, utilization review, and assessment of physician performance. This article examines the reasons for using physician profiling, current uses of physician profiling, information provided by physician profiles, achievements of physician profiling, and barriers to implement physician profiling based on the different US experience. Physician profiling enables consumers to select the most appropriate physician, educate physicians to review their practice styles, and health plans to achieve cost containment. The use of physician profiling to monitor or review individual physician practice behaviors has been widely employed by group practices, health plans, and state and federal governments in the US. The information on physician profiling can be categorized into two kinds, i.e. physician background information and performance information. However, although many US studies have demonstrated that physician profiling improves the quality of medical care and reduces total health expenditures, some barriers still exist. The high costs related to the development of physician profiling is a good example. The physician profiling movement has apparently created a sentinel effect on health delivery for physicians based on the public performance information. The healthcare industry in Taiwan should focus on the physician profiling system to provide high-quality information of physician performance to the public for assuring the quality of medical care.