I have been writing about "physician profiling" for years. It is a negative term that can basically be substituted for pay-for-performance. The insurance company uses this data to steer patients where they want them to go. For example, if a doctor is deemed to not meet their quality standards or any other criteria they make up, the managed care companies can black ball them or increase copays for patients to see them. One problem, among so many, is the validity of their data. Add to this the lack of appeals process and you have a catastrophe in the making. The New York Times is reporting that the AMA is fighting back. That's nice. It should last until they get some donation from some managed care organization representative or they just fold under the pressure.