FOCUS seal: TOP doctors

Every year, FOCUS-GESUNDHEIT presents Germany's top doctors in collaboration with the independent research institute MUNICH INQUIRE MEDIA (MINQ). The big FOCUS-GESUNDHEIT doctors' list 2018 will be published on 5 June 2018.
The methodology for the FOCUS-GESUNDHEIT doctors' list 2019 will be updated in June 2019.

These are the quality criteria:

Survey
The monothematic magazine FOCUS-GESUNDHEIT commissioned the research institute Munich Inquire Media (MINQ) to determine the top doctors in Germany. MINQ uses five different evaluation parameters and quality criteria to compile the FOCUS-GESUNDHEIT list of doctors:

1. physician evaluations: Since 1996, MINQ has relied on the tried-and-tested peer procedure in which doctors assess colleagues in their speciality. The interviews are conducted in accordance with journalistic standards and are subject to full protection for informants. Doctors were interviewed throughout Germany who, according to the status of the research, have very good medical expertise. These include senior doctors, senior physicians and chief physicians, medical directors, leading members of medical associations and experts. In the first stage of the survey, doctors can freely recommend colleagues. They are then asked to assess doctors from a defined research pool. For each survey, medical specialists can also register free of charge with MINQ at https://www.minq-media.de/registrierung/ for inclusion in the research pool.

2. patient reviews: Self-help groups and patient associations often have excellent insider knowledge. In many cases, they co-operate with doctors and keep their own recommendation lists of medical professionals. MINQ has been conducting surveys of self-help groups and patient associations and collecting recommendations since 1997. MINQ also analyses doctor rating portals on the Internet.

3. publications: In addition, MINQ determines how many specialist articles a doctor has published in the past five years. The data is based on the PubMed medical database (https://ncbi.nlm.nih.gov/pubmed). This contains the most important national and international journals from all medical specialities. A doctor is assessed in the categories "published" and "frequently published".

4. certificates: Other qualification criteria include certificates obtained by doctors, which MINQ researches from public sources or collects in collaboration with professional associations. The involvement of patients in studies also plays a role. Patients can gain access to the latest therapies through clinical trials.

5. questionnaire: The doctors contacted as part of the research were also given a questionnaire in which they could provide information about themselves, their range of medical services and their practice. MINQ worked with recognised experts and leading representatives of medical associations to develop the questionnaires.

Evaluation and identification of the top physicians:
Once the data has been collected, MINQ collates all the research sources and analyses them systematically. To be included in the FOCUS list of doctors, a doctor must have above-average results overall within his or her speciality. This applies in particular to doctor recommendations. The list of around 3,200 doctors is divided into a total of 77 indications, whereby a doctor can be recognised for several indications.

You can find more information on the methodology athttp://www.minq-media.de/methodik/

MEDICS 2019 TOPFOCUS-HEALTH 04 | 2019

 

Recommended doctor in the region

Finding a good or the right doctor is of great interest to patients. For almost 25 years, Focus magazine, together with the research institute Munich Inquire Media, has been listing Germany's renowned specialists for a range of illnesses following extensive research. Since January 2017, recommendations have also been made for choosing a doctor in the outpatient sector. Focus - Gesundheit is cooperating with Stiftung Gesundheit (Hamburg) on this research. Stiftung Gesundheit is a non-profit foundation with legal capacity under civil law. It was established in 1996 and is constantly monitored by the foundation supervisory authority. Its committee members and advisory boards are appointed from all over Germany. The research is carried out there by a qualified team, is based on objective criteria and is based on Arzt-Auskunft, a service that has been providing patients with comprehensive information on medical care services since 1997. The doctors who perform best in the research are given a "FOCUS recommendation" for their region by the editorial team.

The FOCUS approach

Empirical data provides the most reliable judgement for assessing the quality of diagnosis, treatment and care. This is why FOCUS's research is based on objective methods. This creates transparency, improves competition and provides the general public with a reliable basis for choosing a doctor.

Data basis

Since 1997, Stiftung Gesundheit has been offering the Arzt-Auskunft - a service that informs patients about medical care services, lists addresses of medical facilities and collects medical information on doctors and analyses it scientifically according to objective criteria. The processes, quality criteria and internal quality control are structured in line with the ISO 9000 standard. The 20-strong research team is trained in medical professional law and medical terminology, among other things. The data protection officer supervises the work. For the FOCUS recommendation, Focus - Gesundheit has developed a series of evaluation criteria based on information from the Stiftung Gesundheit foundation. Only doctors in their own practice or in a medical care centre as well as representatives of those medical fields that are in high demand (more than 350 representatives nationally) and psychotherapists are included.

Evaluation criteria and score calculation

The most important underlying evaluation criteria are listed in descending order of importance:

Recommendation by colleagues (medical reputation)
Specialist and additional qualifications in accordance with the further training regulations
Member or officer of a professional association
Year of establishment
General or coordinating participation in disease management programmes (DMP)
Expertise
Lecturing activities
Quality management
Patient satisfaction
Patient service
Accessibility
Publications


The doctor receives points for each criterion that is fulfilled or partially fulfilled. These points are added together to give an overall score. For most criteria there is a maximum number of points that can be achieved, e.g. lecturing activity is not included in the score with more than a maximum of 2 points. The criteria of colleague recommendation and specialist and additional qualifications are theoretically unlimited. The most influential criterion is the recommendation of colleagues - every recommendation improves the doctor's score. No points are deducted for criteria that a doctor does not fulfil.

The Focus seal "Recommended doctor in the region" is awarded to those doctors and dentists who are among the 10 per cent of doctors and dentists with the highest overall rating in their respective district and in their medical field of activity.

Using this methodology, FOCUS is able to recommend the doctors in each district who have achieved the highest regional scores. As the maximum points achieved vary per district and speciality, there is no minimum number of points required to be recommended.

Justification of the selection of criteria and their relevance



Colleague recommendation

When asked by Stiftung Gesundheit, the doctors state which of their colleagues they themselves would go to if necessary and which colleagues have convinced them of their expertise in interdisciplinary collaboration. The doctors surveyed can name up to ten doctors from their own or other disciplines.

According to studies, peer reviews are the most reliable source of information for assessing the quality of treatment provided by doctors. Focus and Focus - Gesundheit have been focussing on this criterion since 1993.

Colleague recommendations are collected annually via an online survey conducted by Stiftung Gesundheit.

Score relevance: We honour a higher number of colleague recommendations with more points in the score calculation. There is no upper limit to this criterion.

Specialist and additional qualifications

Specialist and additional designations are awarded by the respective medical association. They are linked to the successful completion of several years of theoretical and practical training and the successful passing of an examination. They are recognised by the state and may be displayed on the practice sign. Additional designations are special qualifications that doctors can obtain in numerous areas specified in the further training regulations.

Specialist and additional designations are also determined via the continuous survey conducted by the research team.

Score relevance: We reward doctors who have made the considerable effort to gain further qualifications via several specialist designations and additional designations with more points in the score calculation. There is no upper limit to the criterion.

Officer/member of professional association

The specialist societies that are members of the German Association of Scientific Medical Societies (Arbeitsgemeinschaft der Wissenschaftlichen Medizinischen Fachgesellschaften e.V.) are taken into account.

Doctors who are involved in their specialist society are well networked, keep up to date with the latest scientific developments through congresses and events, discuss their medical views with colleagues and are recognised there as experts. They take part in the current professional and healthcare policy discourse, the creation of guidelines, congress organisation, promotion of young talent and other specialist society tasks.

The AWMF member societies' officers are surveyed annually by Stiftung Gesundheit directly with the societies.

Score relevance: Membership as a functionary is honoured with more points than simple membership.

Year of establishment/professional experience

Brief description: Number of years in the doctor's practice. In principle, it can be assumed that medical quality increases with a doctor's experience. However, studies on the treatment quality of medical specialists, measured in terms of years in practice, are heterogeneous. Although the learning curve for practical actions on patients increases in the first few years (or with the number of cases), the willingness to adhere to the guidelines decreases. This dichotomy is represented in the evaluation by the fact that the increase in experience is taken into account positively for each year of practice, but this does not increase further after 15 years of practice.

The years of establishment are determined by the continuous survey and questioning of the medical profession by Stiftung Gesundheit's research team. This is done by telephone enquiry with doctors, Internet research, independent reporting by doctors to Stiftung Gesundheit or its partners.

Score relevance: We honour a longer period of establishment with additional points up to a maximum value of 15 years.

Disease management programmes (DMP)

Disease management programmes (DMPs) are structured treatment programmes for the systematic treatment of chronic diseases. The health insurance funds or health insurance associations conclude contracts with suitable service providers. DMPs are currently offered for bronchial asthma/COPD, breast cancer, diabetes and coronary heart disease (CHD). One of the main elements of the disease management programmes is standardised and structured electronic documentation. The medical documentation data is collected by the coordinating doctor during the regular follow-up checks (quarterly or every six months).

Participation in the DMP is determined by Stiftung Gesundheit via self-reporting. Participating doctors help to reduce existing care deficits (overuse, underuse and misuse) and thus improve the quality of care.

Score relevance: A coordinating activity is rewarded with more points than a participating activity.

Expertise

The association Medizinrechtsanwälte e.V. brings together the trusted lawyers of the Medical Law Consultancy Network. A number of doctors co-operate with the consulting lawyers as medical experts.

Doctors appointed as experts are recognised as experts by their colleagues and by the legal profession. Their expertise and experience are above average. Experts have the professional knowledge to pass judgement on the work of colleagues - and are therefore also in a position to correctly assess the quality of their own treatment. The medical law advice network of Medizinrechtsanwälte e.V. offers patients and doctors the opportunity to take advantage of a free legal counselling session with one of the association's trusted lawyers. The members of the association and the attorneys of confidence recommend doctors to each other who provide expert opinions - also in specialised fields.

Score relevance: The activity as an expert is honoured in the score. The number of appraisals produced does not affect the score.

Lecturing activities

Speakers at scientific-medical conferences or congresses.

Doctors who report to their colleagues on their own experiences or studies they have conducted or who present and discuss the current state of knowledge are considered to be particularly qualified. Current lecturing activity is rated higher than past lecturing activity.

The research team evaluates the programmes of the relevant specialist congresses, records the speakers and identifies the doctors in the doctors' directory.

Score relevance: In the score, the lecturing activity is honoured regardless of the specific number of lectures given. Current lecturing activity is scored higher than past lecturing activity.

Quality management system (QM) certified

This takes into account whether a practice has introduced a quality management system (mandatory) and has also certified it (voluntary).

In 2006, the Federal Joint Committee (G-BA) defined the requirements for an internal QM system for medical practices. Since January 2011, all medical practices must have implemented a QM system and self-assessed it once a year. Stiftung Gesundheit's research team identifies the certified practices by means of self-reporting by doctors.

Score relevance: It has a positive impact on the score if doctors have also certified their QM system.

Patient satisfaction

The long-standing survey of patient satisfaction - a joint campaign by numerous public portals - is carried out in the categories of organisation and service, appearance, staff, doctor and the question of whether the practice would be recommended to others. According to studies, subjective patient satisfaction is a relevant criterion for evaluating doctors.

The patients' doctor ratings from the partner portals involved flow directly into a recommendation pool of Stiftung Gesundheit, where they are aggregated and analysed.

Score relevance: The higher the average rating in the Stiftung Gesundheit recommendation pool, the more points (up to a maximum limit) from this area are included in the score.

Accessibility

Rooms and facilities that are accessible and usable for all people are described as barrier-free. This includes, but is not limited to, people with disabilities of various kinds. The components of accessibility surveyed in the medical practices are
Ground level or step-free access
Lift is wheelchair accessible
Lift is barrier-free
Adjustable chairs/loungers
Sign language
Orientation aids for the visually impaired
WC is partially barrier-free
WC is barrier-free
Practice is wheelchair accessible
Disabled parking spaces


The "Accessibility" component reflects practical aspects of the practice that are important for patients with disabilities.

At the beginning of 2010, all doctors, dentists and psychological psychotherapists in Germany were contacted for the first time and informed about the issue of accessibility. Since then, Stiftung Gesundheit has regularly surveyed the status of accessibility in outpatient medical care.

Score relevance: The more criteria are fulfilled, the more points (up to a maximum limit) from this area are included in the score.

Patient service

The following factors of the practice are taken into account in the area of patient service:

E-mail address available
Homepage address available
Focal points are indicated
Accessible by bus and train
Reminder of check-up appointments
Home visits are offered
Car parks available
Service available in the waiting room
Weekend consultation hours are offered
Evening consultation hours are offered
Further consultation hours are offered by appointment


The "Patient service" component reflects the practical aspects of the practice that are important to many patients.

These patient service factors are continuously collected from doctors and doctors also provide this information on their own initiative for the purpose of publication.

Score relevance: The more criteria are fulfilled, the more points (up to a maximum limit) from this area are included in the score.

Publications

The criterion takes into account doctors whose scientific publications are listed in the PubMed directory of medical-scientific research papers, the portal of the NCBI (National Center for Biotechnology Information, US National Library of Medicine).

With over 26 million "citations", PubMed is one of the largest and best-known databases of medical literature. Doctors who have published one or more scientific papers have had to deal intensively with medical issues and their study situation and can be considered particularly qualified in this specialist field.

Score relevance: Publication activity is honoured in the score. The number of published works itself does not affect the score.