Physician performance information and consumer choice: a survey of subjects with the freedom to choose between doctors

Background: Increasing efforts have been made to provide information to help consumers to select a healthcare provider, but the public release of hospital performance data has had only a limited impact on consumer choice. Objectives: To understand the experience of consumers in searching for physician performance information and to investigate the potential impact on their propensity to change doctors if hypothetically provided with physician specific performance information. Design: A nationwide telephone interview survey using a structured questionnaire. Setting: The survey was conducted in Taiwan, a country with a universal health insurance programme where residents are free to choose between physicians for any medical consultation. Participants: 4015 adults aged over 20 years contacted by random digit dialling telephone calls. Main outcome measures: Subjects were asked (1) if they have ever compared the quality of care provided by physicians in their area; (2) if they would consult a performance report if it was available; and (3) if they would change doctors on the basis of information provided in the report. Results: Approximately half the subjects had made comparisons between doctors; 73% stated that they would consult a performance report if it was available, and 77% were prepared to change doctors if their doctor performed badly in the report. Conclusions: Providing physician specific performance reports to the public may be viewed favourably by consumers of health care and have a significant impact on physician selection and hence quality improvement.