Online Doctor Ratings Are a Blessing and a Curse
By SHARI ROAN, LOS ANGELES TIMES
Distraught over the results of cosmetic surgery on her nose, Katherine Chen did what many people do when they’re unhappy with a doctor. She consulted a malpractice lawyer and filed a complaint with the state Medical Board.
But the 22-year-old college student didn’t stop there. Chen logged onto her home computer and wrote a tearful review about her experience, posting it to a Web site that encourages consumers to rate their health-care providers.
“I wasn’t nasty about it,” says Chen. “But I posted a comment about what I went through. These Web sites are useful. Doctors still have a lot of power.”
Chen and other consumers are trying to rein in that power. They’re saying what they think about the current state of health care and, more specifically, the doctors who provide it. Dozens of Web sites that permit people to rate, review, spin or flame their doctors have sprung up in the last year, operating in much the same way as online services that help people find hotels or plumbers.
Patients and site operators say the trend is good for consumers and good for health care. Thoughtful doctors, they say, will provide better customer service because of the feedback, and the bad ones will no longer be able to hide. And, they add, why should doctors be immune from the trend toward better customer service?
Many physicians say the reviews on RateMDs.com, Vitals.com, DrScore.com and other sites are skewed by disgruntled patients and are unfair, pushing some doctors to near-ruin after a single post.
Reviews affect docs
“These sites don’t yield enough power yet to get bad doctors to change. And in the meantime, they may hurt good doctors,” says Dr. Phyllis Hollenbeck, author of “Sacred Trust: The Ten Rules of Life, Death and Medicine,” a new book promoting patient empowerment. “It only takes one or two scathing comments and a doctor is put in a terrible position.”
The sites, more than two dozen of them, vary in their scope of information and efforts to be fair. But the trend is toward free, anonymous, no-holds-barred forums.
Some sites have grown out of existing ratings services. Five years after he started the hugely popular RateMyProfessors.com, John Swapceinski and his business partner launched RateMDs in 2004.
“You can find ratings on cars and flat-screen TVs, but it’s hard to rate professional services,” he says. “I think that’s overlooked.”
The operators of Vitals.com in Lyndhurst, which launched in January, say their goal is to provide free, fair and balanced information to help people select a doctor.
“We think of it as something closer to Match.com, in which we want to match up patients with doctors who are right for them,” says Mitchel Rothschild, chief executive.
The restaurant survey company Zagat has even teamed up with the health benefits company Wellpoint Inc., parent company of Anthem Blue Cross, to provide Blue Cross members with an online tool to evaluate doctors. The service allows members to issue scores based on trust, communication, availability and environment.
Once reverential of doctors, many U.S. consumers are more comfortable criticizing physicians, says Dr. Kevin Weiss, president of the American Board of Medical Specialties, an organization that sets performance standards and certifies doctors.
“There is a lot of pent-up frustration,” Weiss says. “Costs are going up, and people are paying more out of pocket. Plus, there is a lot of data now on how the health-care system needs to do better in terms of quality and safety.”
“There is a lot of protection for doctors,” Swapceinski says. “Even with the state medical boards, there is recognition that doctors policing doctors is not the best way to handle things. Most complaints about doctors are never made public.”
Some state medical boards provide consumers with limited information on doctors, such as any disciplinary actions recorded and whether their licenses are current. Moreover, state governments, insurance companies and private organizations have attempted in recent years to gather data on physician performance that can be compiled into “report cards” to help consumers choose doctors wisely. Such measures have been shown to improve health-care quality, according to the Agency for Healthcare Research and Quality.
Dr. Richard Fischel, a thoracic surgeon, says his life was turned upside down after a patient began posting vicious remarks online regarding a surgery Fischel performed.
One doc’s nightmare
The surgery was an elective procedure, Fischel and the patient discussed the pros and cons, and the patient signed a consent form acknowledging that discussion.
The operation went well, Fischel says. But after the surgery, the patient complained about a previously discussed side effect that can sometimes occur as a result of the surgery.
“He decided his life was ruined and destroyed,” says Fischel.
Online, Fischel says, the patient posted “slanderous rants and raves.”
Fischel, who can’t reveal details because of a legal agreement he has since reached with the patient, soon discovered the pervasive power of the Internet. His business was affected and he suffered monetary and emotional costs because of the patient’s postings. Fischel hired a lawyer and became so depressed he considered leaving medicine.
Federal laws protect patient privacy and prohibit doctors from discussing an individual’s health care in public. But the right of patients to criticize their doctors online has been established. Federal law asserts that the hosts of Web sites on which consumers post anonymous opinions are immune from charges of defamation.
The operators of RateMds.com read every comment and delete ones that are “blatantly libelous,” Swapceinski says.
Some sites, such as Wellpoint’s Zagat, will not post doctor ratings until 10 consumers have weighed in. DrScore.com, founded by a doctor, allows only numerical ratings no anonymous comments.
RateMDs.com attracts about 450,000 visitors a month and has 600 to 1,000 new posts a day.
But many doctors think the sites are of limited value and that consumers could be as easily led astray as informed by them.
Physician organizations support evaluating doctors with empirical measures and making the information public as long as it’s fair, says Dr. Nancy H. Nielsen, president-elect of the American Medical Association.
In January, the AMA released a statement urging consumers to ignore anonymous doctor-rating sites, saying they “have many shortcomings.”
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On the Web
* RateMDs.com: Provides a 1-to-5 rating scale in four areas: staff, punctuality, helpfulness and knowledge. Consumers can add anonymous comments and join a member forum to chat about a doctor.
* DrScore.com: Allows consumers to rate doctors anonymously using a 1-to-10 scale. Only aggregate ratings are posted. Doctors can subscribe to detailed reports that analyze the data provided by consumers.
* Healthgrades.com: 90 percent of information on doctors is free, including doctors’ education, training, insurance plans, group practice information and aggregate numerical patient satisfaction ratings. The site does not post anonymous consumer comments.
* Vitals.com: A free service from Lyndhurst for consumers that provides three types of information on doctors: consumer ratings and comments, credentials and experience, and doctor-peer reviews. Doctors can contribute information on themselves to the site. The site also helps consumers select an appropriate doctor for specific symptoms or conditions.
* Nursesrecommenddoc tors.com: Enlists nurses to provide anonymous ratings and reviews of doctors they work with or who have cared for them or family members.
* Angieslist.com: Membership-based service that allows consumers to rank and review various service providers, from gardeners to doctors. Service providers are ranked with a letter grade on price, quality, responsiveness, punctuality and professionalism.
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(c) 2008 Record, The; Bergen County, N.J.. Provided by ProQuest Information and Learning. All rights Reserved.