By Evan Falchuk

Yesterday’s USA Today reports on a list of doctors the newspaper is making available for free to its readers.  It’s a good lesson in  how complicated and conflicted health care is – and how hard it can be for consumers to figure out what’s really happening.

Of course, I support the idea of getting as much useful health care information to consumers as possible, including lists of doctors.  But a look at how the USA Today list was put together reveals much more than just the names of doctors.

The company USA Today hired to provide its list is one of many similar companies that do sales and marketing research for the pharmaceutical and managed care industries.  Their job is to profile doctors by crunching through reams of claims data.

It’s part of the complicated dance of health care spending.  Pharmaceutical companies want to profile doctors as a way of efficiently using their sales force.  Knowing which doctors are the best targets for your sales and marketing efforts is very valuable.  This way, you don’t waste time selling Lipitor to a doctor that already prescribes it 80% of the time.  Meanwhile, managed care companies want to profile doctors for the opposite reason.  They want to know which doctors have high rates of prescribing brand-name drugs to they can encourage them to switch to generics.

I’m sure these systems work, since pharmaceutical companies and managed care companies spend tens of millions of dollars on them.  But it’s not at all clear how a list created for this purpose can have much to do with what is actually important to consumers when they are sick.  Or why any of these companies would want to reposition themselves in this way.

One possibility can be found in the halls of the Supreme Court.  Over the last few years, some states have passed laws banning the commerical use of doctors’ prescribing information.  This is the lifeblood of these profiling companies, and so the leaders in that industry have filed lawsuits to have these laws overturned.  If they lose, the business of these companies will disappear, or will have to drastically change.

Maybe they’re trying to find a new business.

UPDATE: More here.