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Doctor ratings by patients
Old 07-05-2007, 07:12 PM   #1
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Doctor ratings by patients

Here is an interesting site, taking the ebay seller rating model to doctors. Patients rate their doctor and provide comments. It's got a good search engine as well, so you can search within a certain distance of your zip code, by specialty, by rating, etc. I think this is a good concept, though it may be biased from patients who have a beef against their doctor, or maybe from those who like their doctor for good bedside manner rather than good medicine. It's probably useful in cases of doctors with many ratings, especially if all the ratings cluster around the top or the bottom. Plus, since patients leave comments, one can read what the patients like or dislike about their doctors.

I can't really use this myself right now, since I use the military health system, but maybe those of you with more choices can use it. Now, if someone would extend this concept to car mechanics, that would be a winner.

RateMDs.com - Doctor Ratings and Reviews
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Old 07-05-2007, 07:34 PM   #2
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This site started as Rate My Professor dotcom and then branched into rate my doctor. There is a Canadian version and now it's spreading to other countries too. There has been a good deal of paranoia in the medical profession about it. Of course the data are not "peer reviewed" or validated. Nevertheless they do give some idea about customer service.

I did once browse looking for doctors that I know. (I didn't find any ratings of myself). There are bad doctors who deliver unsafe care who are rated very highly, and there are decent, safe doctors who obviously never learnt the meaning of customer service! One of my outstanding colleagues gets top ratings, and someone that is competent but that I don't like personally was called rude. I think there is not a strong correlation between customer satisfaction and competence.

Customer service is important. Also important is the outcome of your care. No point in having a nice doctor who kills you! Other indicators, such as complication rates, length of hospital stay, etc. are increasingly being made available in the public domain. Some of these indicators have less to do with the individual doctor than with the team or the institution. In any case, when quality of care indicators are published, the public doesn't seem to use the data in making decisions about where to go for care. Can any of the forum members speculate why that might be? Is it because people who like their doctors don't look at the outcomes, or don't believe what they don't want to hear?
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Old 07-05-2007, 07:44 PM   #3
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It's an interesting concept - couldn't find myself or any colleagues, and most listed have just 1 or a few ratings. Really it's not much different from any other Web-based rating system for a complex service or product. Taken with a grain of salt and the usual due diligence required by the internet, it might have some value.

It will obviously never be a sufficient means for picking a doctor. But if you belong to an HMO with only 5 internists in your area, why not look at their rating. Not scientific but if 8 of 10 complained about her rudeness, tardiness, unintelligible accent or some other consistent and important issue it's better than nothing.

Of course, the real problem will be getting in to a good doctor's practice as the primary care shortage looms.
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Old 07-06-2007, 01:30 AM   #4
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Originally Posted by Rich_in_Tampa View Post
It's an interesting concept - couldn't find myself or any colleagues, and most listed have just 1 or a few ratings. Really it's not much different from any other Web-based rating system for a complex service or product. Taken with a grain of salt and the usual due diligence required by the internet, it might have some value.
Can the families rate the doctors of the dearly departed?

Talk about your "survivor bias"!!
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Old 07-06-2007, 06:50 AM   #5
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In any case, when quality of care indicators are published, the public doesn't seem to use the data in making decisions about where to go for care. Can any of the forum members speculate why that might be? Is it because people who like their doctors don't look at the outcomes, or don't believe what they don't want to hear?
Where are those quality of care indicators published? Maybe they are not used because most people don't know they are there, or if they are there, they may be difficult to obtain.

I'm probably not the best guy to speculate about doctor choices, since I've been within the military health system most of my life. But based on the times I've had to find civilian doctors for myself and family, my guess is that patients initially find doctors based on convenience to their home or work, on recommendations from friends and neighbors, from insurance lists, or from referrals. I suspect that if outcomes were easily available this would become a factor, but probably not an overriding factor in doctor choice, unless there were negative results. Patients would steer away from a doctor with a bad reputation much easier than they would migrate towards a doctor with a good reputation.

There may be exceptions to that for tricky health conditions where specialists are needed, or for ob/gyn where facilities for both expectant mother and child become important. I note that most of the doctor ratings I've seen are for ob/gyn.

I found one interesting doctor on the ratings list close to where I live. He has almost uniformly negative ratings due to his poor attitude towards his patients. But he gets one high rating from a patient who lauds him for his knowledge, but admits he has a poor attitude -- he compares him with Dr House on T.V.
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Old 07-06-2007, 07:59 AM   #6
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Originally Posted by Meadbh View Post
In any case, when quality of care indicators are published, the public doesn't seem to use the data in making decisions about where to go for care. Can any of the forum members speculate why that might be? Is it because people who like their doctors don't look at the outcomes, or don't believe what they don't want to hear?
I would venture that the vast majority of people don't know that quality of care data exists. And if they do, they probably have a hard time finding it. If someone asked me where to get such data, I wouldn't know what to tell them.....check the hospitals website or perhaps your insurance companies website? Also, the quality of care metrics that are available seem to be primarily for hospitals and not usually for individual doctors. For individual doctors, patient ratings/comments are probably more useful at the moment.

For the most part, people use doctors when they have a health issue. If it's an emergency, no one is going to be checking the ratings to see what doctor they should use. It's off to the ER to get immediate attention from someone. For routine physicals and the like, what is there to distinguish one doctor's performance from another doctor's performance? Nothing really except customer service....was the doctor attentive, did they listen to your concerns, did they ask logical questions, did they get you in for your appointment on-time, etc. (Maybe doctor's should be required to track on-time performance like the airlines.) The only situation I see where quality of care metrics are valuable are for non-emergency surgery. In these situations, people can take some time to review their alternatives and choose appropriately.
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Old 07-06-2007, 08:23 AM   #7
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To further complicate using such information, quality of care measures in health care are very tricky and open to mis-interpretation. Some are easy: how often does a primary doctor advise well-accepted screening tests.

Others are tricky: diabetic control for example; depending on where your practice is, how willing you are to see underinsured patients, etc. you are selecting patients whose lifestyle choices or conditions have more effect than how "good" your doctor is.

At the extreme, you even have some doctors who are known as the "go to" person for especially difficult cases. They do that better than anyone but their outcome quality compared to the general medical community is awful, because their patient "mix" is so skewed.

So while everyone tried to hide behind adverse patient mix when they get rated poorly and sometimes it is just an excuse, the reality is that it make comparative data very difficult to use.
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