"You ought to be able to choose your own doctor" has become the battle cry of many politicians who hope to ride the current backlash against managed care plans to electoral victory this November. As we have noted previously, this sound-bite approach overshoots legitimate concerns about cost-driven decisions by health plans concerning treatments and access to specialists. It also threatens to unravel managed care's one major accomplishment: breaking the back of health care inflation (and the associate rise in the ranks of the uninsured) by eliminating the money-is-no-object ethic of the old fee-for-service system of health insurance.

Many health care plans, of course (especially the preferred provider organization, or the PPO model), allow some consumer choice of both primary care and speciality physicians. But whether you are talking about choosing physicians under managed care or under the old fee-for-service system, how, exactly, do consumers choose wisely? After all, Marcus Welby, MD, has retired. Do you rely on word of mouth? Advertising (strongly discouraged and limited by the profession)? Convenience? Referrals from other physicians? Trial and error?

The truth is that it is much harder to knowledgeably chose a doctor than a car, a school, a house, or even a health plan. "Freedom of choice" is pretty meaningless without the ability to make an informed choice.

In Massachusetts, you can make a phone call or go onto the Internet and immediately get basic information about any of the 27,000 doctors licensed to practice medicine in the state. Thanks to legislation sponsored by State Sen. Mark Pacheco (D- Taunton), a member of the DLC's State Legislative Advisory Board, the State Medical Board prepares and updates "physicians profiles" that provide: