HMOs' and hospitals' physician report cards may not be all that useful, according to a U.S. Agency for Health Care Policy and Research study. The authors say conclusions about physicians are often based on too few patient encounters — sometimes, as few as four — to be of value. "Science does not support such reckless use of numbers for judging physicians," wrote coauthor Sheldon Greenfield, M.D., in the Journal of the American Medical Association.
Separately, a Health Services Research study documented degrees of differences in utilization among primary care physicians. While there were insignificant distinctions between family practitioners and general internists in inpatient and lab use, utilization was higher for internal medicine subspecialists. Pharmacy and admissions were 17 and 33 percent greater, respectively, than for generalists. FPs referred to gynecologists, dermatologists, and psychiatrists 14 percent less often than generalists.