Consumer Reports ranks Minnesota doctors on diabetes, cardiovascular care

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• Northland clinic ratings

Consumer Reports, the magazine that compares cars and washing machines, has come out with a Minnesota-only comparison of doctors.

Working with the nonprofit Minnesota Community Measurement, the magazine compared 532 practices and offered the results in a 32-page insert in its October edition for Minnesota newsstands and subscribers. The Minnesota version of the magazine has its own cover.

The ratings are derived from the percentage of patients who meet various targets for two conditions: diabetes and cardiovascular disease. The targets include giving up such areas as giving up smoking and managing blood pressure. The results were compiled and rated, Consumer Reports-style, from 5 for higher performance to 1 for lower performance. The 37 clinics that achieved 5s in both categories were ranked as top-scoring practices.

None of the top scorers were in Northeastern Minnesota, but a couple of clinics came close. Cromwell Medical Clinic, which is part of the Integrity Health Network, had a 5 for diabetes care but wasn’t ranked for cardiovascular care. It doesn’t have enough cardiovascular patients to generate the data needed for the report, said its director, Dr. Shawn Bode, in an e-mail. The Essentia Health Ely Clinic was ranked 5 for diabetes care and 4 for cardiovascular care.

On the other hand, 13 Northeastern Minnesota clinics rated a 1 in either or both of the categories.

The accompanying article is quick to point out that, overall, the state fares well.

“Minnesota has the best performing health-care system in the country, just edging out Wisconsin, according to a recent report from the Agency for Healthcare Research and Quality,” the article notes.

And Northeastern Minnesota doesn’t significantly lag behind the rest of the state in physician care, said Jim Chase, president of Minnesota Community Measurement, which has been providing health-care data since 2004.

“There’s no one region in the state that is far behind the others,” Chase said. “The Northeast is a little lower than the median, but there’s variation in all regions of the state.”

That variation can be seen even within health systems and networks. Northland Family Physicians in Duluth, which is associated with Integrity Health, scored 4s in both categories. But Duluth Family Practice Center, also associated with Integrity Health, scored 2 in diabetes and 1 in cardiovascular health.

Bruce Penner, who is director of quality for Integrity Health and served as an editorial reviewer for the Consumer Reports article, said the differences were understandable.

“Very simply, they’re different clinics,” he said. “They’re different cultures.”

Chase said the characteristics of a clinic’s patients — such as age, genetics and income level — can make it difficult to attain high scores.

“There are sites where you can understand it would be very hard for them to be at the top of the list because they have very challenging patient populations,” he said.

More important than a clinic’s score is its improvement, Penner said. Across the Integrity Health Network, the percentage of patients achieving diabetes benchmarks rose from 9 percent in 2009 to 38 percent in 2011, he said, and similar gains had been recorded in cardiovascular care.

The report brands as a myth the idea that quality care is only available in the Twin Cities. Cromwell is an example of a place where smaller rural can be better.

“Being small, I think we can really know our patients and, hopefully, better treat them as individuals,” wrote Bode, the clinic’s lone physician. “I think we are a pretty good mix of old-fashioned care blended with using the latest tools and technology.”

Dr. Joe Bianco, a clinician at Essentia Health Ely Clinic for 22 years and director of primary care for the Essentia system, attributed the good results in Ely to early use of electronic medical records and a team approach in working with patients.

“Getting us to the top is that motivational work that we do with our patients,” Bianco said. “When the patient is challenged by a whole team of people who are all cheering for him there’s kind of a synergy.”

That approach is being used across the Essentia system, he said.

The article marks the second time Consumer Reports has focused on health care in one state. It rated Massachusetts doctors in May.

Chase said the partnership grew from the magazine’s readers wanting health-care information and from his agency wanting the public to know about its findings. “Consumer Reports has a lot of experience on how do you talk to the public,” he said.

But choosing a doctor is not the same as buying a washing machine or a dishwasher, he said, and patients shouldn’t abandon a doctor with whom they’re getting good results just because of low numbers.

Instead, low numbers can be a cue to have a conversation with your doctor, Chase said. “Ask them questions. What are they doing to try to improve their results? We’re trying to get people to have a dialogue.”

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