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
Here are our recommendations:
- Ensure that every potential rater who claims to be a patient of a particular physician really is one.
- Require a meaningful number of raters. Given that the average physician sees 1,000 to 2,000 patients in a year, ratings that involve only two or three patients are meaningless. Forty or 50 ratings are another story. Comments could be collected until a threshold number is reached. They could then be published.
- Require patients to stick to areas in which they are expert—namely, subjective impressions. A physician’s personality, staff, and communication skills are fair game. Skill at performing oophorectomy—out of bounds. However, should a patient wish to have the physician’s technical skills reviewed by a trained professional, all the better.
For example, to deputize the patient as a partner in preventing spread of infection and wrong-site surgery, a survey can ask: “Do you recall if the doctor washed her hands before she examined you?” (The answer is informative only if the office asks the patient, upfront, to make this observation.) Another question: “Did the doctor ask you to mark your name on the affected limb before surgery?”
The feedback loop will either confirm great performance or serve as a strong motivator for fast improvement. Both physicians and patients must participate to make the health-care system better.
Even when reviews are positive, the experience of being rated on the Web is a little disconcerting.
Why?
Most reviews are anonymous, and few, if any, patients have the background to fully understand why a particular treatment succeeded—or did not. That’s the view, at least, of two ObGyns interviewed—both of whom serve on the Board of Editors of OBG Management.
Steven R. Goldstein, MD, has been glowingly reviewed on Angie’s List, but still finds the value of online rating dubious. Dr. Goldstein is professor of obstetrics and gynecology at New York University School of Medicine and director of gynecologic ultrasound and co-director of bone densitometry at New York University Medical Center in New York City.
“There’s nothing scientific or objective about it,” he says, particularly when it comes to assessment of complex medical treatment. “Patients can say how they felt about the person,” he adds, but their ability to evaluate the scientific and technical components of treatment is limited.
Barbara S. Levy, MD, agrees. She is medical director of the Women’s Health Center for the Franciscan Health System in Federal Way, Washington.
“I think people can rate their experience,” she says. “I don’t think they can judge training and surgical skill.” Dr. Levy has been rated positively on several Web sites.
Neither physician had read any reviews of their services. Both are “kind of” aware that online rating is increasingly common.
“It’s happening in everything,” Dr. Levy says.
Is there reason to worry about a poor rating?
Dr. Levy believes that anonymous reviews should be prohibited. “Not that a site has to publish the names of reviewers,” she says, “only that whatever agency is allowing them to do the reviewing should be collecting their information to make sure they are legitimate. It’s just due diligence.”
Dr. Levy does believe that patients should have the right to review their experience with physicians. As for what to do about an unfair review, “I think it’s only fair for the doctor to be able to rebut it,” she says.
Dr. Goldstein has a slightly different take on the matter.
“I don’t really have the time or energy to devote to this issue,” he says. “I like to think that patients who come to me do so because of other patients, whom they know fairly well, or other physicians.” If a patient sees one negative Web review and chooses not to use a doctor on that basis, “there isn’t much I can do about it,” he says.
“The most important part of this issue”—online rating of physicians—“is that it is totally unsubstantiated.”—JANELLE YATES, SENIOR EDITOR
What we are doing now
Our company is working with rating sites that share our understanding of the problem and endorse our proposed solutions. Bad information can be worse than no information, we argue! If health care is to be improved, patients and physicians need high-quality information about providers and health-care systems. By injecting fairness and accountability into online ratings, we will all benefit.
