How Does Your Doctor Compare? Specialty-Adjusted Prescribing Analysis
A family doctor prescribing 5% opioids is very different from a pain management specialist prescribing 5% opioids. Raw numbers are meaningless without context. OpenPrescriber uses specialty-adjusted peer comparison — comparing every provider to their specialty peers using z-scores — to identify true outliers. No other public tool does this.
110
Specialties Tracked
1,077,163
Total Providers
3
Key Metrics
Z-Score
Methodology
The Z-Score Approach
A z-score measures how many standard deviations a value is from the mean. For each provider, we calculate z-scores for three key metrics relative to their specialty peers:
- Opioid Rate: What percentage of their prescriptions are opioids?
- Cost per Beneficiary: How much does their average prescription cost?
- Brand Name %: How often do they prescribe brand over generic?
A z-score of 0 means average for their specialty. A z-score of +2 means they are 2 standard deviations above their peers — placing them in roughly the top 2.5%. This is the threshold we use to flag statistical outliers. This approach ensures a pain management specialist isn't unfairly compared to a dermatologist, and vice versa.
Specialty Benchmarks
The table below shows average metrics for each specialty, sorted by number of providers. Click any specialty to see its full profile.
| Specialty | Providers | Avg Opioid % | Avg Cost/Bene | Avg Brand % | P95 Opioid |
|---|---|---|---|---|---|
| Nurse Practitioner | 218,535 | 3.8% | $1,174 | 8.9% | 23.1% |
| Internal Medicine | 110,156 | 2.2% | $1,411 | 10.6% | 8.3% |
| Physician Assistant | 109,535 | 9.2% | $719 | 6.7% | 49.0% |
| Family Practice | 106,889 | 2.6% | $1,068 | 9.0% | 8.4% |
| Dentist | 70,845 | 5.7% | $14 | 0.1% | 28.7% |
| Emergency Medicine | 44,021 | 9.4% | $78 | 1.5% | 23.7% |
| Student in an Organized Health Care Education/Training Program | 36,424 | 4.3% | $622 | 6.2% | 35.1% |
| Optometry | 22,807 | 0.0% | $611 | 40.1% | 0.0% |
| Obstetrics & Gynecology | 22,639 | 1.3% | $376 | 12.1% | 8.4% |
| Pharmacist | 21,761 | 0.3% | $489 | 91.9% | 0.0% |
| Psychiatry | 21,141 | 0.1% | $1,696 | 4.9% | 0.0% |
| Cardiology | 18,720 | 0.1% | $1,524 | 13.6% | 0.2% |
| Ophthalmology | 17,757 | 0.5% | $600 | 36.7% | 0.5% |
| Orthopedic Surgery | 17,619 | 31.0% | $62 | 0.8% | 67.1% |
| Hospitalist | 16,767 | 3.0% | $427 | 5.2% | 9.9% |
| Gastroenterology | 13,928 | 0.2% | $1,956 | 14.4% | 0.8% |
| Podiatry | 13,314 | 6.9% | $128 | 3.2% | 28.4% |
| Dermatology | 13,195 | 0.6% | $1,209 | 7.5% | 2.9% |
| Neurology | 13,194 | 1.3% | $4,034 | 9.4% | 5.6% |
| General Surgery | 13,124 | 30.2% | $253 | 5.0% | 73.1% |
| Psychiatry & Neurology | 10,307 | 0.2% | $1,323 | 5.1% | 0.0% |
| Urology | 9,928 | 3.4% | $714 | 6.3% | 13.2% |
| Pulmonary Disease | 9,082 | 0.2% | $5,138 | 61.4% | 0.9% |
| Nephrology | 8,961 | 0.4% | $1,283 | 9.0% | 2.0% |
| Otolaryngology | 8,957 | 5.4% | $132 | 3.3% | 26.1% |
| Hematology-Oncology | 8,541 | 6.3% | $14K | 14.6% | 18.0% |
| Physical Medicine and Rehabilitation | 7,404 | 20.2% | $455 | 3.1% | 62.6% |
| General Practice | 7,389 | 2.5% | $1,128 | 8.4% | 11.3% |
| Endocrinology | 6,382 | 0.1% | $3,933 | 51.2% | 0.0% |
| Infectious Disease | 5,387 | 0.5% | $8,010 | 21.3% | 3.2% |
| Oral Surgery (Dentist only) | 5,119 | 20.6% | $20 | 0.1% | 43.2% |
| Rheumatology | 5,101 | 4.1% | $6,039 | 7.6% | 15.0% |
| Interventional Cardiology | 4,479 | 0.0% | $1,054 | 13.1% | 0.0% |
| Allergy/ Immunology | 3,536 | 0.1% | $3,515 | 27.3% | 0.0% |
| Medical Oncology | 3,372 | 5.9% | $12K | 13.4% | 17.2% |
| Radiation Oncology | 3,327 | 9.4% | $224 | 5.9% | 30.4% |
| Anesthesiology | 3,186 | 34.8% | $422 | 4.7% | 70.8% |
| Pediatric Medicine | 2,743 | 1.6% | $2,098 | 15.1% | 6.7% |
| Vascular Surgery | 2,716 | 11.4% | $430 | 15.2% | 41.0% |
| Pain Management | 2,621 | 41.2% | $399 | 3.8% | 74.3% |
Showing top 40 of 110 specialties by provider count. View all →
Highest Opioid Prescribing Specialties
Why Peer Comparison Matters
Most public prescribing transparency tools show raw numbers — total claims, total cost, whether a provider prescribes opioids. This approach is fundamentally flawed because it ignores the clinical context of different specialties. An orthopedic surgeon who prescribes opioids for post-surgical pain is behaving normally; the same rate from a dermatologist would be alarming.
OpenPrescriber's specialty-adjusted approach solves this. By computing statistics within each specialty group, we can identify providers whose patterns truly deviate from their peers. This is the same methodology used by CMS in its own internal fraud detection algorithms, but we make it publicly accessible for the first time.
Whether you're a patient researching your doctor, a journalist investigating prescribing patterns, or a researcher studying Medicare spending, peer comparison provides the context necessary for meaningful analysis.
Try it yourself: Peer Comparison Tool → | Flagged Providers → | All Specialties →
Data source: CMS Medicare Part D Prescribers dataset, 2023. Z-scores are calculated within specialty groups with n≥30 providers. Statistical outlier identification does not imply inappropriate prescribing. This analysis is for educational and research purposes only.