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Dr. Ezekiel Emanuel recently penned an editorial with the provocative title "In Health Care, Choice is Overrated." In the editorial, Dr. Emanuel defends the practice of insurance companies offering a smaller network of physicians to their customers (also known as "narrow networks") in order to reduce costs. Understandably, people wrote back in defense of choice. Putting aside the controversial core of the issue, Dr. Emanuel calls for measures that we can agree with: more transparency and more reliable ways of measuring quality.

In terms of transparency, Dr. Emanuel suggests that insurance companies should be required to publish their metrics when they assess physicians. We think that would be a great idea. If nothing else, that will amplify the discussion on what quality means within the health care context. Dr. Emanuel also advocates developing a more reliable way of measuring quality. Ideas on how to measure quality in health care have been around for decades. The problem there might not be developing the guidelines themselves (as difficult of a task as that might be), but actually getting the information in order to implement the grading system. Doctors frequently chafe at the idea of their performance been assessed, and doctors have also been reluctant to share detailed information needed for a meaningful assessment. Sure, these are great ideas, but when will they be implemented? Would Dr. Emanuel be so confident in his statement that "choice is overrated" if these measures aren't in place?

We've long held that quality means different things to different people. A Harvard physician conducted a quick Twitter survey on "what makes a good doctor" and received over 200 responses. The top response category only garnered 18% of the total vote. Surprisingly, "competent/effective" only came in at 6%. It could be that most of the respondents gave their answer assuming a sufficient level of competency.

What's also interesting is that none of these response categories (e.g. "humble") are easy to measure. It's possible that there are some reasonable proxies for these attributes. Some might argue, for example, that being accepted into a prestigious residency program likely means that the person is intelligent. (Even supporters of this theory would agree that the converse is not true: that is, not all intelligent doctors were accepted into prestigious residency programs.) Others might argue that positive patient reviews often correlate with good bedside manners, which might encompass a number of the response categories (e.g. "empathetic," "good listener"). If you have ideas on how people can find good doctors, please let us know.

The trend towards price transparency in health care has been afoot for many years now, and it still might be many more years before we see anything like other industries. As another encouraging sign of this continuing trend, NPR recently posted a story about how Massachusetts now requires health care providers to disclose costs of procedures to prospective patients. The article chronicles the travails of an expectant mother trying to figure out how much labor and delivery would cost at nearby hospitals. Unfortunately, there's no requirement for providers to disseminate this information in a form that is easily interpreted by computers so that websites can incorporate the data to help patients shop. Instead, patients need to resort to the phone, navigating switchboards and voicemail systems. Even worse? Some providers are not complying with the law.

Isn't the whole idea of having to call around to find prices reminiscent of a much older era? Didn't price comparison websites for travel pop up in the nineties? For a sector that consumes about a sixth of the nation's GDP, one might hope for a more transparent marketplace. Maybe some year.

For a while, we've been noticing some search queries for which we didn't return results. Sometimes, people were searching for a concept that was too specific, and sometimes, people were searching in areas where we didn't have as detailed coverage. To help address this, we've released a new feature that suggests related topics.

For example, if you were to search for providers in Sunnyvale, CA who have listed "Mycosis Fungoides" as a clinical interest, you would get back four results, but you'd also see a link to search for Cutaneous T-Cell Lymphoma (mycosis fungoides is a type of cutaneous t-cell lymphoma). By trying out the suggested link, you might find other providers that are in the general ballpark of what you're looking for.

This site will be taken offline tonight (February 13, 2014, after 9 PM PST). Hopefully, the site will be back up within a couple of hours.

For those curious, we'll be changing colocation facilities.

Update: the move was successful.