* * Anonymous Doc: Reviewing doctors

Sunday, March 11, 2012

Reviewing doctors

There is a New York Times article this weekend about the Internet lacking useful sites with doctor reviews. Here.

The writer comes to the conclusion that more patients should write reviews of their doctors, so that more information is out there....

I don't know. I expect the people most motivated to go online and review their doctor aren't going to be the ones who are particularly happy. Of course, we already deal with that situation for everything else we review. Restaurants, etc. But at least with restaurants, we know whether we like the food or not. I think one problem with doctor reviews is that we don't usually know whether our doctors are actually practicing good medicine, following the right treatment plan, prescribing the best medications... everyone gets sick, everyone eventually dies of something. Maybe a doctor helped you, maybe a doctor hurt you, I don't think patients always know. Maybe the doctor did all the right things, and the outcome sucked. Maybe the doctor did all the wrong things and the problem went away on its own.

I think the other problem with doctor reviews is that the kinds of things patients can review are not the same things as you should really care about when it comes to your medical care. Wait time. Politeness of staff. Friendliness of doctor. Magazines in the office. Availability of appointments. Yes, all of these things are important, sort of. All else being equal, sure, I'd rather have a friendly doctor with competent staff, and not have to sit in the office for two hours waiting. But some of these things aren't necessarily in the doctor's control-- hiring staff, if part of a larger practice or a hospital, for instance-- and all of them are seriously secondary to the real value a doctor provides-- figuring out how to best treat your illness. If I'm the patient, I would rather have a brilliant, thorough, up-to-date clinician who's completely unpleasant than a very nice incompetent moron.

I should qualify that, I suppose. For something easy, most doctors are probably fine. But we don't come into the office with signs around our necks saying what's easy and what's hard, what's a common cold and what's a rare syndrome. And for complicated situations, you want the doctor who knows what he or she is doing, even if he's a jerk. Better if he's not a jerk. But I'd rather have to deal with a jerk than die of, say, Legionnaire's disease.

This isn't quite an argument against online doctor reviews. Sure, the more information, the better. And people should know not to trust everything they read.


  1. Agreed. I've been preaching this for a while. Couldn't have said it better.

  2. The only true way to have an online doctor review, however, is allow the doctor's to repudiate a claim. They can't do that or it portend to violate HIPAA. Either way, then, the doc is screwed.

    I think the magazines that do a Top 100 are as good as any for sources of doctor reports. Those magazines, I believe, take suggestions and nominations from both other docs and population at large.

    With that, I think you get a decent idea. If your doc is on the list, awesome! If the clinic your doc is at, awesome! If not, maybe it's time to dig a little deeper.

    In either of those cases, the docs are not needing to refute erroneous, misleading, and damning information from a disgruntled patient; nor are they needing to worry about HIPAA.

  3. Pointless! As a patient the best of my reviews would be if I liked the doctor or not - I don't have the training to comment on the level of care. Perhaps these online reviews are better called "beside manner reviews."

    If I am looking for a physician it would be helpful to have comments and reviews from those in the field; can a patient really comment on the skill of a surgeon? (My scar looks nice?) not likely. Right now our best source is another doctor; though largely you are trusting the opinion of someone else you really don't know anything about.

    Would it be helpful (from a patient perspective) to have access to physician performances evaluated by other physicians? Maybe. But the challenges to providing such information to the general public are infinite.

    Is the answer to have a bunch of people not educated in the field to make a recommendation? I'll take my chances on the doctor I don't know very well.

  4. A lot of those 'Top Doc' lists are based on pretty minimal material for how seriously many people take them. Last I heard about my local one is that they asked their coworkers who they would recommend. It sounds more like a popularity contest than actually looking who has the best outcomes, best service, etc.

    This is a hard topic because people should be able to rate their experience and that is how they recommend doctors to their friends but I also agree that people have to take recommendations of this with a very very large grain of salt.

  5. When I read the rate my professor site to check out a teacher before I sign up for a class I rarely agree with the commenters so I'm pretty sure a doctor review would be even less helpful. As it is now I kind of look to see which teacher has the worst comments and then go with them because so far every teacher I have loved has been one everyone hated. I have one now that everyone loves and I do not really like her. If the people are reviewing how much they like the doctor that is kind of useless because, like you, I would rather have a doctor that is an ass and can treat what's wrong with me than a nice one who can't.

  6. As a patient (from a different country, but I don't think that matters), I must say I am very grateful for such sites and I use them, I believe, to my benefit and to the benefit of others.
    First, let me say that I've written a a couple of doctor reviews and most of them positive, and as a patient with chronic problems I am much more motivated to write those. Why? As you said, as a non-expert, I may not allways know when the doctor is not competent enough, but it's usually a lot easier to recognise an extremely competent doctor.
    Second, the bedside manner aspects are extrememly important. I've seen many patients ingnoring the (I would guess good) advice they've been given because the physicisan just didn't know how to communicate it properly and make the patient trust them.
    Third, as a reader of those reviews, I think I can differentiate well what matters / is reasonable and what is not. If most of the reviews claim "he helped me with something I've had for years and no one was able to do anything about it", it is probably a competent doctor. If a review says "he suggsted pain medication that can be taken only for two weeks for something that is recurring and, from experience, I know I allways suffer from pain for at least four months" (something I've once written), and there is more reviews suggesting obvious incopetence like this, I know he probably isn't. If many of the reviews say how "terrible" he is, I don't know if he is or isn't competent. But, based on the details the reviews give on that "terribleness", I can safely assume if that would be a problem for me or not.
    Pardon my English :D

    P.S.: This blog is great.

  7. Hallo! Love your blog, think you have not really considered the patients here. They write about what is important to them. For example - a 2 hour wait may not be a doc's fault, but if you cannot be late picking your kid up, you cannot afford that wait no matter why it is there. Maybe bedside manner is more important to you if you are chronically ill than if you only see a doc sporadically.

    I think that dangerous people that managed to get educations and jobs as doctors are few and far between - but they exist in the dark cracks that things like review sites shine bright lights into.

  8. Yes, I definitely agree with Patient C, above regarding wait times. In the overall scheme of things it's not important, but it really can matter if you're a parent. I would also add that extended wait times in a pediatrician's office are not acceptable. I wouldn't leave a peds clinic/practice over an isolated incident, but I have transferred my son's records to another clinic after *repeated* waits of 45+ minutes. Another thing I've found is that when you receive care from a practice where long waits are the norm, the nurses and staff tend to be very harried and sometimes downright rude. It's completely understandable, but it's not something I want to deal with.

    I will say though, if I had access to an organization's Press-Ganey scores, those would have absolutely no bearing on my decision to be a patient there. Over the past couple of years I've received 4 surveys (1: ER department, after a visit for gallstones; 2: Medical/surgery care for cholecystectomy; 3: Outpatient stay for tubal ligation, and 4: PCP's office). Each survey was returned without being filled out, and with a letter explaining that I refused to participate because I found the questions to be overly simplistic and insulting to the hard work that physicians, nurses and staff provide.

    Plus, it's a given that the vast majority of people who take the time to fill out those surveys are patients with complaints about their care. And those are people, also, who tend to have unrealistic expectations and demands of their healthcare providers.

  9. I reveiwed my doctor online recently because he is great and I had this weird desire to let everyone else know that he is great. I've been seeing him for nine years and sometimes it's been really simple for him and I also have had two more complicated things and each time I have felt well treated, well looked after, that he had done his research and READ MY CHART. And he's nice, I don't have to wait often, its easy to make an appointment. I don't care about magazines - his waiting room isn't nice but his office equipment is shiney and new. So I did it - reviewed my doctor. Maybe it's odd, but there you go. I felt good about it.

  10. Please just go through with online doctor reviews I only believe in that it is really helpful.