Sunday, June 03, 2012

More About On-Line Doctor Reviews



I wrote about my experience of getting a one-star review of my psychiatric practice on HealthGrades.com. 
I wrote about it on Shrink Rap: Here

I wrote about it on Clinical Psychiatry News: Here
and I wrote about it on Psychology Today: Here.


Some of the responses have suggested that patients/clients should be able to write such reviews and that people should be able to look up information about their doctors.  Well, they are, these sites exist and you can also look up whether your doc has been sanctioned on your state's licensing site.  

 I thought I would address some of the comments in new post


As I mentioned, I Google new docs before I see them, and I would be put off by a bad review.  There are good docs and mediocre docs and bad docs.  I'm not sure how I feel about doctors being reviewed on line.  On my Psychology Today post, a couple of college professors came on and noted that students who get poor grades review them harshly.  I know waiters who have been fired because of gripes put up on Yelp, some of them rather subjective.  The online world is full of pressure.


Should doctors be the focus of On-line ratings?  They are, and maybe that's okay, but I have specific gripes with how this is currently done.  Let me outline those gripes.


1) My information is put up without my permission or consent.  It includes a map to my office.  Some doctors  work alone in isolated settings and may feel unsafe having this information on the internet.  We should at least be asked.  Oh, and the information is wrong, the address listed has not been my address for years.  The websites don't seem to care. They want me to register with their sites and correct it.  I want nothing to do with them, so I'm not registering with them and my information may as well be wrong.  It's public information, you say?  There are lots of things that are "public information"  everything from legal case searches and home addresses.  Does that mean that anyone who wants has the right to put it on their website?    Public information-- would you want someone searching you and putting up on their website every speeding ticket you'd gotten, every DWI, every bill collector's claim, your age, your home phone number and address, and any licensing violation --on their website?  It's all public information but does that give a third party a right to publish it?  Legal, yes.  Ethical--I don't think so.  HealthGrades took my listing down when I requested it.  Vitals.com, however, tells me that I have no option to not be listed with them.  I'm still chewing on that.


2) Ratings should not be anonymous and there should be some way to ascertain that the reviewer has really been a patient of the doctor, otherwise these reviews are worthless.  Some commenters (I think mostly on the Psychology Today website) feel that being able to write reviews empowers patients, but if someone who doesn't know a doctor (or an angry neighbor, ex, etc) goes in and writes poor reviews, or if the doctor or his friends go in and write great reviews, then there really is no empowerment on either end.  In order for their to be any usefulness or empowerment to these sites, the ratings need to be done honestly. 


3) There should be a mechanism to remove a review if the rater changes their mind.


4) The issues being rated all reflect individual taste and subjective interpretation and don't reflect 
good medical care.  There are no questions about "Did the treatment this doctor recommended cure or alleviate your problem?"   There is a question about how quickly you get seen in an emergency, but what does that mean?  If the doctor talks to you and says "Go to the Emergency Room" is that bad?  He didn't SEE you.  If the doctor is on vacation but his coverage sees you, does that count?  Do we really care about the lighting in the waiting room?  What about, "Did your doctor seek consultation or refer you to a specialist appropriately?"  That's not a question.  How long did you wait?--that's a question. Do you want a doctor who is always on time?  Convenient, yes, but it means that he holds to his schedule religiously-- he doesn't squeeze in emergencies, and if he's telling you that you're going to die of cancer soon, you only get your allotted time to ask questions and don't go over because he's holding to his precise schedule.  Does your doctor listen and answer questions is a reasonable question.  Did he spend the appropriate amount of time with you? Again, isn't this an individual call?  Some people are chatters, some are not.


5) I don't understand why HealthGrades will take down behavioral health ratings.  I asked, they didn't answer.  You can rate a psychiatrist, it's not that they block it, it's just that if the psychiatrist complains, they take it down.  This really negates any value and skews the results in favor of the doctor (at least in theory, I think most doctors believe they are powerless and there is no recourse, and don't actually ask to have their reviews removed). 


Roy, here's a career for you: create a website that provides a public service of rating doctors with some verification of who the reviewer is, with questions that reflect both warm and caring treatment as well as good medical care.  And ask the docs to participate.