Dead doctors stubbornly alive on physician-finder sites
■ A practical look at information technology issues and usage
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Patients searching for an ob-gyn in the Fountain Valley, Calif., area might come across a listing for Miriam Wysocki, MD, on several physician-finder sites.
They will learn that she's located on Warner Avenue, that she accepts Health Net Insurance plans, and that she has been a physician for more than 50 years.
But good luck getting an appointment with Dr. Wysocki. She's been dead for several years.
Many physicians have complained that physician-finder and -rating sites that are popping up online often contain inaccurate information. It's not just the dead doctors -- it's the physicians who have their home phone number listed instead of their office number, or who are listed as accepting insurance plans they no longer take.
The operators of these sites admit that there are problems when it comes to outdated data.
But, they say, the data are accurate far more often than not, and the data are better than what was available before their websites existed.
The issue of deceased doctors still listed as practicing was brought to several of the sites' attention when Barbara Duck, a health IT consultant from Westminster, Calif., wrote about the issue on her blog, The Medical Quack. Dr. Wysocki was Duck's physician before she died. Duck found Dr. Wysocki's listing while doing research on another doctor with the same last name.
She saw the first listing on HealthGrades and thought, "There's something wrong here." She called the number listed for Dr. Wysocki's office, and it was disconnected.
She decided to see where else the doctor was listed, and found her on eight physician finder and rating websites, as well as one site that helps connect patients with physicians for clinical trials.
For Duck, the issue raised many questions, most of which center around the overall accuracy and reliance of the sites. The site operators claim the issue underscores the need for more physician involvement.
Aaron Goddard, physician data manager for HealthGrades, said Duck's blog "pointed out a pretty big fundamental issue that we have with our data." He said the biggest issue is handling physicians who die prematurely. "It's very tough for us to find that information out," he said.
Goddard explained that HealthGrades has a process of reviewing physicians older than 80 or whose graduation year is at least 50 years in the past. Other than that, the company relies on third parties -- such as insurers and state medical boards -- from whom they receive data, to inform them of changes.
They mostly rely on users who leave comments about inaccuracies, and the physicians themselves. Most sites have links on each physician's profile page that take the user to a form where inaccurate or outdated information can be reported.
Goddard said HealthGrades is working with several medical societies and associations in an effort to educate them on the need for more physician involvement. "We're trying to make sure that the physician is responsible for their Web presence," Goddard said.
Steven Feldman, MD, PhD, the founder of Medical Quality Enhancement Corp., a Winston-Salem, N.C., company that runs the website DrScore.com, said he, too, would like to see more physician involvement.
Dr. Feldman said his site started with a list that was made up of publicly available data from state medical societies.
"Over time, those data do become less accurate," he said. "Visitors to the site, as well as medical practices, often provide us updated information. When they do, we go to the state medical board websites and confirm the updated information."
He acknowledges that the process isn't perfect.
"There very well could be dead doctors in our database," he said.
Former AMA President Nancy Nielsen, MD, PhD, said the public websites have many shortcomings, and patients should not rely solely on them when making a decision on a new doctor. She said patients are better served asking current physicians or local hospitals for referrals, or by using websites such as the AMA's DoctorFinder, or those belonging to state medical boards.
Candis Cohen, public information officer for the Medical Board of California, agrees the medical board is a good resource for people looking for a physician. Its database would reflect whether a physician's medical license is active and also would show any disciplinary action taken against a physician -- something independent rating sites would have no way of knowing unless each physician was checked individually on an ongoing basis.
Cohen said changes to a physician's license status in California are made in real time and that the database the board maintains is constantly updated to reflect those changes.
But even the state medical boards are sometimes behind in reporting a physician as deceased, because that physician's licensing status would first change to a delinquent status when he or she failed to renew.
Goddard said he realizes that it is HealthGrades, not the data sources, whose reputation is at stake when wrong data are published.
But, he said, HealthGrades gets it right far more often than it gets it wrong. "We have a high threshold for accuracy," he said, adding that it continually evaluates vendors from whom it receives data and severs ties with those whose accuracy rates aren't up to par.
Duck, who has computer programming experience, said keeping track of information such as addresses, phone numbers and disciplinary action on each physician's listing would be nearly impossible for an independent website operator. But he said an easy solution to the problem of dead doctors is to use the Social Security Administration's death index database, which costs only a few hundred dollars.
Goddard says the database would not be helpful, because it gives only names and addresses. But according to Duck, a simple computer program could be written to cross-reference the names and addresses in the Social Security database with the names and addresses in the physician profile database. When a potential match is found, it could be red-flagged for the sites to check up on it. It would be just one additional tool the sites could use to help improve their accuracy, since this is a difficult problem to fix.
"Dead doctors cause a lot of problems, don't they?" she said.