Speaker Presentation from U.S. News Healthcare of Tomorrow leadership summit, Nov. 1-3, 2017 in Washington, DC. Find out more about this forum at www.usnewshot.com.

1. Elitism and Population
Density Bias

2. Fame often a Lagging
Indicator

3. Bigger is NOT Always
Be@er!

4. We Prefer What We Know
Best!

5. Objective Data Be@er,
But….
• Little good comparative outpatient quality data.
• Perfect is the enemy to the good so surrogate data
better than purely reputational basis for comparing.
• Objective data will get better over time and will/
should take on greater importance.
• Always will be flawed by imperfect risk adjusting.

6. Reputational Can Be
Improved
• Surveys adjusted for population density and
randomly selected. Drop Doximity!
• Cannot rank a program where they trained or in the
state where they practice. Told if they do, the
ranking will be disqualified.
• Five attempts to get a score before giving up.
• Rank three programs in order with weighted score
(1. gets 5, 2. gets 4 and 3. gets 3 points).
• Make this 50% of the total score.

7. Surrogate Objective Data
• Use BRIMR NIH rankings of total support divided by
number of MDs and PhDs on their web-site.
• NIH funding per person 25% of total score.
• RPB publication rankings also objective and
published. Also divide this by the number of MDs
and PhDs on their website for 25% of the score.
• Now half reputational and half based on objective
findings that have been independently validated.
• There are many criticisms I can think of but so much
better than the present system and its inherent bias.
• Switch to risk adjusted outcomes as they develop.