Great pair of articles in the Paper Of Record (in the Business, not Health, section) on Friday looking at websites that rate doctors (here and here). The gist: you can get a wealth of reviews on pretty much any restaurant you live near through various sites, but very few docs have multiple reviews of them online. The first link goes into some depth as to why this is so, and concludes with the thought that the only way to get more accurate info about the doctors is to have more people put up more reviews. Which is true, although since many people already put up Tolstoy-length reviews of their local coffee shop, it stands to reason that people are still a bit uncomfortable about doing the same with docs.
The only guess I can hazard is that most people still put docs into a different category of job than those that are both clearly customer-service oriented and, for lack of a better word, capitalist. Hairdressers, auto mechanics, electricians and the like exchange services out of a specialized knowledge for cash; priests, teachers, and docs also do that but are in some sense responsible for our souls. Rating a priest seems like an exceedingly odd thing to do, and I suspect that doc ratings haven't caught on for a similarish reason.
That said, it seems reasonable to assume that sites like RateMDs.com and the doc section on Angie's List will inexorably gain adherents and the practice will become more widespread. Not every physician--based on the comments in the second NYT article--is delighted about this. "The biggest problem is that it is the patient point of view which is often emotionally charged and not fully informed. If I tell a patient they have cancer and they don't like the diagnosis, am I rated poorly because 'that's not what I wanted to hear'?...I often ask the complaining patient 'Did you get better?', 'Is your loved one still alive?' and then which was more important to you, staff friendliness or the outcome?" wrote Doc Matt. (A delightful reply came from Miriam in Queens, who wrote, "You mean I can't have both?" One does wonder about Doc Matt's bedside manner when he explains that he "often asks the complaining patient" about their critiques: how many complaints does he get?!)
Such condescending attitudes weren't the only ones in evidence, but these and other comments do highlight the anxiety ratings are capable of promoting. From my own experience in professional chit-chat with colleagues, many more of us are worried about getting a malpractice lawsuit than a bad online review, but that could just as easily reflect the kind of doctoring I do (that is, not outpatient clinic-based) than it does the general mood of practicing docs.
One good point made in the comments that surprisingly didn't find its way into the articles dealt with the lopsided rules by which docs and reviewers can approach the online rating system. Patients can say whatever they wish in a review, but docs are bound by confidentiality, and are unable to respond if they feel they have a misleading review. However I'm not sure that any but the most thin-skinned docs would respond to bad reviews anyway, since it would likely make matters worse from a marketing standpoint, and just might indicate an underlying problem with feedback that lots of patients associate with certain kinds of docs in the first place.
The articles are good and informative, though journalist Ron Lieber does include one unintentional howler by noting that "the American Medical Association speaks for most doctors". While undoubtedly an important organization to reckon with, the AMA ain't all that, a topic we've previously covered here. But in terms of the overall ointment, it's a pretty small fly.
UPDATE: I received a comment from a reader who feels as if a doctor was responsible for their spouse's death. The reader named this physician and the medical group for whom the physician works. I won't publish the remark: I cannot verify the information and thus can't in good conscience allow a direct attack on a particular physician onto my blog. The reader is more than welcome to circulate the story on the websites above, but here I can't sanction specific accusations without the ability to verify the veracity of the claims. I tried to send an e-mail to this person directly but no address comes up on the link. If you wish to discuss further, please leave another comment with your address. I'm happy to entertain thoughts about tough times with physicians but my rule is to keep names out of it (as I wrote about experiences with one of my father's physicians here). I am sorry for your loss. Best, Billy