Wednesday, November 25, 2009

Health

Comarow on Quality Graphic

Is the Ratings Game Stacked Against Doctors?

March 18, 2008 12:40 PM ET | Avery Comarow | Permanent Link | Print

Like my colleague Michelle Andrews, I've been following the proliferation of doctor-rating sites. And like her, I can see theoretical value in them. They could be a good tool when seeking a primary-care physician—someone who should have good people skills besides a solid base of medical know-how: the ability to listen between the lines, to say, "I don't know," to look at his patients and truly see them.

I'm bothered, however, by the viral spread of these sites and by how thin and potentially misleading they are. Yes, Web users know at some level that what they read about a doctor hasn't been carefully vetted. Do they mentally apply a correction factor when they read a post flaming (or overpraising) a doctor? Maybe they do. But it's hard. How do you put words on the screen into perspective when you don't have any? And it's so easy to take swipes on an anonymous website. It's no news that our online personalities are different, and not necessarily for the better.

Take my primary-care physician. He's a good listener, doesn't rush me, thinks outside the box when necessary, and possesses other qualities, like a mischievous sense of humor, that I value. He's also somewhat reserved, which a couple of people I've referred to him told me they didn't like. They found him lacking in empathy. I can imagine their comments on one of the physician-evaluation sites. I can imagine how some might read those comments and cross him off their list of potential providers. "Who needs a cold fish?" they'd figure. In my opinion, crossing him off before trying him out would be unfortunate and unwarranted.

I don't think doctors should be rated as if they were restaurants or plumbers. (Angie's List, which posts consumer ratings for this and other household services, is about to expand to include physicians.) I'm not a client or customer of a doctor; I'm a patient.

But if this trend is an unstoppable force, two elements should be adopted by every website: Comments about a primary-care provider shouldn't be posted until at least 10 are received (five for specialists). And independent facts should be checked.

On the rating site Vitals.com, highly praised by one of Michelle's readers, my doctor was credited with five publications. In fact, the author was a Brit with the same name. I'd already been familiar with the site, and had raised the error with Vitals several months ago. They actually disagreed that it was a mistake, and there it sits even today. Can I be blamed for wondering what else the site might have gotten wrong?

Tags: doctors | websites

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Avery Comarow

U.S. News's Avery Comarow has been editor of the America's Best Hospitals annual rankings since they first appeared in 1990. His reporting on clinical medicine, from the latest cholesterol guidelines to robotic surgery, has been driven by the question: What does this mean to patients? And that is the perspective he brings to his observations and commentaries on the increasing number of programs by hospitals and other healthcare providers to improve care and patient safety.

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