Choosing a Doctor and a Hospital

It's easier to work out which car is safer for your family or which videocamera best suits your needs than it is to find the most experienced sports medicine physician or the best hospital for chemotherapy. In the absence of a Consumer Reports guide to every hospital and doctor in America, these web sites—some free, some fee-based—mine the available data to help guide patients through the maze. (Many insurance company's sites offer similar services: be sure to check yours.)

www.hospitalcompare.hhs.gov This federal government site, a work in progress, uses patient data from more than 4,000 hospitals to assess how often they provide the recommended treatment for certain conditions. For example, you can check the three hospitals you are considering having surgery at to see which is accredited by a private, nationally recognized group, and what percentage of surgery patients received preventative antibiotics one hour before incision. The local hospitals are also compared against the national average, the state average, and the highest scoring hospitals in the country. (Although provision of data is voluntary, the 2004 Medicare reform act gives monetary incentives for hospitals that report to the service.) The site, launched in April last year, currently only measures care given to heart attack, heart failure, pneumonia and surgical patients. It also has a handy checklist of questions to ask hospitals, and your doctor, before making a decision.

www.leapfroggroup.org/cp The Leapfrog Group, a coalition of Fortune 500 companies that buy health care, has a voluntary program that rates hospitals in 28 regions of the country, covering about 50 per cent of consumers. Enter your zip code, city, or the name of the hospital and see which hospitals have fully implemented recommended quality and safety "leaps" for areas like ICU staffing and reduction of medical errors. You can also check the annual volume and outcomes of various high risk procedures, including coronary artery bypass surgery; high risk baby deliveries and neonatal ICU care. The aim: to show the health care industry that "big leaps in health care safety, quality and customer value will be recognized and rewarded."

www.bestdoctors.com Founded in 1989 by Harvard Medical School professors, this service once published books containing names of specialists nominated by their peers as the best of the best. Now, the database of 33,000 physicians is only available online to its members, which include many health insurance and some Fortune 500 companies. Individual referrals are available by contacting the Boston company's office directly.

www.healthgrades.com The restaurant rating system of health care: five stars for the best hospital, nursing home or doctor; three stars for someone who performs "as expected", and one for a poor performer. More than two million users go to this site every month to search its database of 5,000 hospitals, 16,000 nursing homes, and 650,000 physicians. The stars come for free, but detailed reports including survival, complication and recovery ratings cost upwards of $9.95.