I talked a little last week about the perils of new resident physicians starting at teaching hospitals. Not only do new residents relocate in the summer, but a lot of families do as well to take advantage of the gap between school years. Knowing I’m a physician, a new neighbor surveyed me about choosing a primary care doc for the family. Unless you have a doc next door, most people consult relatives, co-workers, neighbors, and friends for recommendations. One hot button area that doesn’t get much coverage in Health IT circles though are online rating services such as HealthGrades, RateMDs.com, Angie’s List, and others.
Remembering my experience with the Medicare Physician Compare website, I decided to find out what I look like on some of the other sites as well as what it would be like to correct errors, should I find them. I started with HealthGrades, which listed me at the correct address at least, but I had no ratings. Although that doesn’t help new patients at all if they are looking for a physician, one thing it does say is that at least I haven’t made anyone sufficiently mad enough that they logged on and gave me a thumbs-down.
Kind of surprising since I make at least one patient a day angry by refusing to prescribe antibiotics when they’re not necessary or by refusing to order unneeded imaging tests. HealthGrades does have a physician portal where providers can update their information or post a response to ratings. I searched two of my friends, just for additional sample size. One who works for a large HMO had no ratings; another who is part of a small private practice had nine. No individual patient comments were posted.
RateMDs.com had me listed at a location where I haven’t practiced in half a decade. I didn’t have any patient ratings, nor did my HMO colleague. My private practice buddy had eight ratings this time, seven of which were extremely positive and one which could not have been lower. Individual patient comments were posted, and the site also had the ability for logged in users to respond to other users’ posts.
Not being a member of Angie’s List, I couldn’t see what we look like there. They do offer the ability for “businesses” to register and see their own profiles but I’m trying to have a bit of a vacation and was tired of fighting the molasses-like hotel internet so I took a pass on registering. Regardless, I’m not sure what I think about being rated as a degreed healthcare provider in the same vein as auto mechanics and tree trimmers. Patients are not SUVs or oak trees. A website that had the potential to be inflammatory was WrongDiagnosis.com, which seemed to just be a redirect to HealthGrades information as opposed to anything sensational.
I talked to my two colleagues to see what they thought about these sites. My HMO connection didn’t think much about it at all – she said it has never really come up with any of her patients and if they have issues with her care, it goes through an internal ombudsman process, which she theorizes is responsible for how quiet her profile was, as well as other docs in her organization that she pulled up. Virtually no one she works with had any ratings either. (We were having a good time searching people we know while we chatted, kind of reminded me of going through the Freshman Annual at college trying to figure out what info we could gather on classmates in the pre-Facebook era.)
On the other hand, maybe for my small-practice colleague, patients felt they didn’t have any other feedback mechanism than the websites. She revealed that she’s had issues with a particular patient in the past, who was terminated from the practice for disruptive behavior. The patient then went on multiple rating sites posting information about my colleague which was found by the state medical board to be unsubstantiated. She and her staff spent what she believes to be hundreds of hours having all the comments from that patient removed.
Determining whether a bad outcome was the result of mistakes by the healthcare team, issues with patient compliance, underlying comorbid conditions or other factors is extremely difficult. In the case of my colleague, from the ratio of glowing reviews to poor ones, it’s pretty obvious that either something dramatically different from all the other visits happened, or that the physician and patient didn’t click. From my limited sample, it’s not clear whether the rest of us are just boring physicians that no one cares to write about, or whether this technology hasn’t really taken off with patients.
If you have an experience with physician rating sites, whether as a provider or as a patient, I’d be interested to hear about it. Until then, I’m headed back to the beach with some Inga-inspired reading material: