Principles on Physician Profiling
The WSMA has adopted the following principles on physician profiling and
the public release of physician-specific data:
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Physician organizations and practicing physicians who are representative
of the profile group shall be meaningfully involved in the development
of all aspects of the profile methodology, including collection methods,
formatting, and methods, means and appropriate audience for release and
dissemination.
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The entire methodology for collecting and analyzing the data shall be
disclosed to all relevant physician organizations and to all physicians
under review.
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Data collection and analytical methodologies shall be used that meet
accepted standards of validity and reliability.
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The limitations of the data sources and analytic methodologies used to
develop physician profiles, as well as appropriate and inappropriate
uses of the data, shall be clearly identified and acknowledged.
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Physician profiling initiatives shall use standard-based norms derived
from widely accepted, physician-developed practice guidelines to be used
primarily to educate physicians.
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Physician profiles and any other information regarding physician
performance shall be shared with those physicians under review prior to
dissemination. Opportunity for corrections or the addition of helpful
explanatory comments shall be provided prior to publication. The
profiles shall either include only data that reflect care under the
control of physician for whom the profile is prepared or shall state to
what extent the data are not under the control of the physician.
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Comparisons of physician profiles shall adjust for patient case mix and
other relevant risk factors, control for physician peer group when
appropriate, and distinguish between the ordering or referring physician
and the physician providing the service or procedure.
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Effective safeguards to protect against the unauthorized use or
disclosure of physician profiles shall be developed and implemented.
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Effective safeguards to protect against the dissemination of
inconsistent, incomplete, invalid, inaccurate, or subjective profile
data shall be developed and implemented.
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The quality and accuracy of physician profiles, data sources, and
methodologies shall be evaluated regularly.
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Physicians should be reimbursed for the reasonable costs that are
required for assembling, formatting, and transmitting data and
information to organizations that develop and/or disseminate physician
profiles.
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The benefits of physician profiling should outweigh the costs of
developing and disseminating the profiles. (CPA Rpt D, A-95)
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Physician-specific information released to the public must be relevant,
meaningful, helpful, and reliable.
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Information released to the public should be conclusive; that is,
information should not be released until a final determination is made.
- Information released to the public should be verifiable.
(CPA Rpt A, A-98) (Reaffirmed A-23)
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Abbreviations for House of Delegates report origination:
EC – Executive Committee; BT – Board of Trustees; CPA – Council on
Professional Affairs; JC – Judicial Council; CHS – Community and Health
Services