Commentary

Editorial: Doctor, Google Thyself


 

My patients fit into three broad categories. There are the patients who love me, there are the patients who worship me, and, unfortunately, there are the patients who hate my guts and share their feelings freely at various online "rate-the-doc"–type websites.

I first made this unpleasant discovery a year or 2 ago. A patient asked me for the address or phone number of a colleague I had recommended. When I Googled that physician, I found that doctor’s address, phone number, maps and driving directions. I couldn’t help but notice that the search also brought up various websites such as healthgrades.com that offered various ratings and/or statistics about the doctor and his or her practice. For an extra $20, I could buy a complete dossier with virtually anything that can be dredged up from the public domain on the Internet, including what the doctor’s kindergarten teacher really thought about little Johnny’s finger painting long before he became a famous neurosurgeon.

By Dr. Larry Greenbaum

Almost instantly, I could feel long-lost neurons in my curiosity cortex lighting up dimly and prodding me to Google myself to see what the Internet paparazzi had to say about me. I quickly caved to the temptation, but it wasn’t a pretty experience.

Based on five or fewer "reviews," I had terrible ratings. Maybe my clinical experience or my busy practice had deluded me into believing I was a great "five-star" doctor, but these websites gave me only one or two stars. As ego deflating as these low ratings were, when I looked more closely, I saw that in some cases, my overall rating was inflated to some extent by good marks for the friendliness or attractiveness of the office, while ratings for my bedside manner and clinical skills were in the basement. "If I were a microwave oven or a computer for sale on Amazon.com, no one who saw those ratings would ever buy me," I moaned! Luckily for me, I don’t have to rely on these websites to earn my livelihood.

I found a number of quaint anomalies on these websites that did little to sooth my ruffled feathers. My education and postgraduate training were curtly summarized. My medical school only garnered a one-star rating, while my residency was listed as three stars. For some obscure reason, my fellowship had a green check mark next to it, but no quality rating was given. Despite very poor grades from a few patients, healthgrades.com listed me as a "HealthGrades Five-Star Doctor." A small pop up box explained that this accolade was based on several criteria, including my affiliation with "a hospital rated highly by HealthGrades." The fact that I seldom set foot in the highly rated hospital didn’t seem to enter into their calculation. Angie’s List reported that none of my patient’s had rated me yet, but with a click or two, I could pull up my medical license number courtesy of the state of Indiana Medical Licensing Board. One website listed my honors and awards to include membership in the American Society of Internal Medicine (ASIM). While I had once belonged to this group, they ceased to exist a long time ago after merging with the American College of Physicians. Since this website didn’t even know that the ASIM was defunct, I couldn’t understand how they could dare to give me such dismal ratings, but there wasn’t a lot of comfort to be gleaned from this small oversight.

I used to have a fat loose-leaf binder from the ASIM filled with advice on building a strong practice. One of the icky pieces of advice I steadfastly ignored was the suggestion of doing a patient satisfaction survey. I was squeamish about soliciting feedback from various angry and disgruntled patients. While I was busy with other matters, the Internet did the dirty work for me, without apology or the slightest regard for my bruised ego. These websites seem to be a magnet for every patient with a gripe and access to a computer.

Consider the following belittling review from an anonymous former patient:

"WHAT YOU DON’T NEED FROM A DOCTOR

Reviewer: Helen (name changed)

"I was attempting to explain new symptoms that arose after two elevated blood tests, which he never bothered to go over, or even look into. When I explained the pain in my hands, which are so much worse now, he directly looked at me and my husband as I was talking and said "Anyways....I guess I’ll see you in 4 months." I went to him to see what was wrong. He labeled me with fibromyalgia and in 6 visits never rechecked me. My test came back that it may be rheumatoid arthritis. Let’s hope the test is wrong because otherwise Dr. Greenbaum may have cost me precious time I needed to prevent this cripling [sic] disease from attacking and disabling me.