TopTierMD: An Entrant in Health Care Transparency?

Health care remains a hot topic these days. And having health insurance seems to have done little to curb my ire. It still stirs a great deal of passion inside me, especially as more and more people find themselves in the same situation I did. The government does not seem too keen on helping, either.

Such passion stirred when I read Ann Meyer’s column in the Chicago Tribune Small Business section, “As more explore business ownership, ask yourself: Do you have what it takes?” A fair, and common question these days. Some of us start businesses out of necessity, some of us because we just always blaze our own trail and some of us because we think we can improve areas where others fall (or have fallen) short.

The focus of the article is a new site,, which seems to be tossing its hat in the health care transparency ring, but with a focus on physicians. I say “health care transparency ring” because Illinois finally decided to abide by the Illinois Hospital Report Card Act. It launched the Illinois Hospital Report Card and Consumer Guide to Health Care at the end of last year. The goal is to provide “information about the quality of health care provided in Illinois hospitals,” which is a fancy way of saying Illinois hospitals are in dire need of quality improvement. And just to put things in perspective, the state passed the Act in 2004. The site launched near the end of 2009. Go figure.

So, The site provides a list of doctors (currently limited to specialists) based solely on the recommendation of other physicians. They ask a simple question: “If you needed one doctor for yourself or a loved one, who would you see?”

Here is their explanation:

To be included as a TopTierMD, doctors must receive the overwhelming endorsement of their peers through a Three-Tiered Selection Process.  The first step in this process begins with a review of “referring” doctors.  Next this group of qualified physicians initiates a thorough evaluation of all physicians within their hospitals.  Finally, once a provisional list of candidates emerges, they are subjected to a final review of peers within their particular specialty.

In the interest of full disclosure, my father is a well established doctor in the local community, and I have asked him a similar question (on more than one occasion) that the founders of pose. His answers are based more on experience and a rather unique perspective. He approaches his practice from as much a business perspective as a medical one, a point that became clear as I start my own company.

First off, I think it’s good that is going through the trouble of thoroughly vetting physicians, essentially culling data and putting it all in one spot. In a way, it skips the step of a Google search, which produces a torrent of results that can take you forever to review, and sometimes take you off course. TopTierMD looks to take some of the guesswork out of choosing a physician, which is no easy feat regardless of whether you’re on an HMO or PPO plan, or have no health insurance at all. There are any number of “bad apples” out there, and medicine is one of those areas you really don’t want to experience a “bad apple” first hand.

However, when hospitals factor into the vetting process, I get cautious. Why? Because hospitals have become more like businesses that consider medicine, the act of helping and healing people, an after thought. Health care reform has shed light on it. And not all hospitals consider medicine an after thought, either. The site also assumes people trust (and believe) their own doctors, let alone doctors recommended by other doctors. I have the benefit of having a father as a doctor, and have known doctors in the community for most of my life so trust is a non-issue for me.

When forced to look outside the community (in college out-of-state), I’m skeptical and use an abundance of caution. Which is not to say people don’t trust their doctors; but with health care reform, doctors seem to be getting their share of skepticism and sometimes anger, along with politicians, insurance companies and pharmaceutical companies. I don’t know that it is wise to assume such explicit trust, but at the moment, I can’t come up with a viable alternative.

It’s too early to tell how well will do. For now, it just shows you standard information like medical school, board certifications, office locations and hours of operation. Nothing about what makes them stand out above the rest. No qualities or “testimonials,” so it seems more like a glorified yellow pages than a comprehensive directory. It’s only distinguishing feature is saving you the trouble of Googling something like “chicago pulmonary specialist” and then sorting through the results.

There is opportunity for, though, to provide a real service. I think it will need to do more, from the patients perspective, but culling a seemingly endless list of doctors is a start. Suffice to say, there is the potential for it to offer more than you’ll get by Googling “chicago pulmonary specialist” so we’ll have to wait and see.


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