Should you worry that patients will use the Web to grade you?
With an anonymous mouse-click on a “frowny face,” anyone can tarnish a reputation that it took you decades to build. But some find pluses to being rated.
IN THIS ARTICLE
Second, health care is rarely provided by one source. A patient’s care is more often collaborative than the product of an individual. Think how many doctors are involved in treating a patient hospitalized for a few days.
Third, more frightening is that many hospitalized patients cannot even identify their physicians. In a survey released earlier this year, three quarters of patients were unable to name anyone in charge of their care. Worse, of those who provided at least one name, 60% gave an incorrect answer. The survey included more than 2,800 patients.1
Last, it is difficult for a patient to evaluate a physician’s judgment and technical prowess objectively. Patients can offer useful subjective information about many aspects of a physician’s skills, such as ability to communicate, but other areas, such as deep technical skills, are less than clear. With the roofer, it’s easy: Either the roof leaks or it doesn’t. Evaluating the details of a gynecologic oncology procedure—well, that’s another matter.
Until 2008, Angie’s List (www.angieslist.com) was known primarily for its reviews of plumbers, handymen, and other contractors. But in March 2008, the Web site rolled out 40 new categories of service providers—all of them related to health care.
The result: 10,000 physician reviews in the first month.
“We just saw a tremendous amount of interest,” says Mike Rutz, Vice President of Angie’s List Health—so much interest that the company increased the number of health-care categories to 150 shortly thereafter, including one for ObGyn care.
Angie’s List is a pay-to-use service with roughly 1,000,000 members in the United States. It differs from other physician-rating sites in other respects as well: Reviews are not anonymous, and any physician who receives a negative review is given the opportunity to respond. In fact, a physician can sign up, free of charge, to be notified when a review goes up on the site. Although the member’s name is not posted on the individual review, it is recorded so that any disputes can be clarified.
“We do have some doctors who say, ‘These people are not my patients,’” Rutz reports. When this happens, Angie’s List can consult its database and resolve the issue definitively.
How is the physician rated?
A patient gives her physician a grade, ranging from A to F, in eight categories:
- availability
- office environment
- punctuality
- staff friendliness
- bedside manner
- communication
- effectiveness of treatment
- billing and administration.
The eight scores are averaged to yield an overall grade.
When a member seeks information on health-care providers in her locality, she sees only the overall grade at first. She clicks through this screen to view the full report.
Rutz believes that most patients have the expertise to judge effectiveness of treatment. “They absolutely know whether the treatment was effective,” he says. He does concede that “the patient is the most important participant in her health care” and does have an impact on the success or failure of treatment. Angie’s List has no plans to remove effectiveness of treatment from the rating categories.
Physicians can encourage positive reviews
Physicians aren’t penalized for encouraging patients to give them a positive review on Angie’s List—in fact, that strategy is encouraged.
“More information is better,” says Rutz. “The folks that are encouraging reviews are usually the folks providing the best service.”
There is an added bonus to positive reviews: Providers who have the best grades and the most reports rise to the top of the list, gaining prominence on the site.
At the same time, there are mechanisms in place to prevent a health-care or other service provider from “gaming the system,” Rutz adds. It is not acceptable for a physician or a member of his or her staff or family to file a review.
So is Angie’s List good news for physicians?
Jeffrey Segal, MD, does not think so.
The problem is that the site requires paid membership, Dr. Segal, founder of Medical Justice Services in Greensboro, NC, says.
“Because of that, [Angie’s List] will never really accumulate more than a handful of reviews on any given doctor; particularly given the number of free sites. And since the average doctor sees over 1,000 patients a year, we do not believe three or four reviews can ever mean anything substantive.”—JANELLE YATES, SENIOR EDITOR
How rating sites need to change
You may conclude that we oppose online rating of physicians. We do not. We understand the desire to know as much as possible about a provider’s abilities. We merely appeal to online rating sites to adhere to minimum standards that promote a responsible system for both physicians and patients.
