Physician rights to privacy of data prevail in two major court tests, but new questions lie ahead.

mation is compiled and transmitted, is far from clear. Historically, publicly available data on physician behavior has been scarce, but the Internet has changed things dramatically. Various Web sites now list disciplinary actions and malpractice judgments, and some Web sites include patient comments. Zagat’s, the company that rates restaurants based on customer input, is reportedly planning to begin scoring physicians in a similar manner.1 None of these data sources has yet faced a legal challenge, although there is concern among many physicians about Web-based patient critiques. Two other uses of physician information are more controversial legally. One is the practice used by large commercial or ganizations, most notably IMS Health, Inc., and Verispan, LLC, now owned by Surveillance Data, Inc. (SDI). These companies compile data from pharmacies on individual physicians’ prescribing practices. The information is then sold to other businesses, including pharma ceutical companies, which use it to guide detailing. This business arrangement has been in effect for many years. The other use of physician information is more recent. It takes the form of Medicare’s recently initiated pay-forperformance (P4P) program, in which physician reimbursement is tied to data that measure compliance with best practices. A consumer organization, Consu mer’s Checkbook/Center for the Study of Services, has sought access to this compliance information through the federal Freedom of Information Act to use it as the basis for publishing consumer guides.