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Some doctors are totally disgusted with the profusion of online doctor rating websites.  I understand why they feel that way.  As great a career as medicine is, it seems horrible to have to worry about online doctor ratings on top of the years of training, the continuing commitment to ongoing medical education, the trials and tribulations of running an office, and the stresses of caring for sick patients.
Are online doctor rating websites like DrScore.com the bows for patients’ arrows at doctors?  That’s not the way I think of it. DrScore is more of a vase to display to the flowers that patients give the doctors that they appreciate.  The vast, vast majority of patients love their doctors, and online rating is way to make those patients visible.  When doctors see the esteem they are held in by patients, I think it will help doctors renew their commitment to giving patients great medical care.

Doctor’s Day is coming March 30. Give your doctors some flowers for their vase by rating them online at DrScore.com.

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Delta Airlines in-flight magazine included a review of wine and business expert Gary Vaynerchuk’s book, The Thank You Economy.  The review said that customer service today is generally poor and that social media will make bad service a much bigger deal.  But it is a double-edged sword: companies can also use social media to give their customers a more personal experience.

This is all half-right when it comes to medical care.  Doctors are giving their patients great medical care day in, day out.  But it isn’t always perfect, and at times patients feel their care is lacking.  The Internet and social media can make mountains out of the negative experiences, ruining doctors’ online reputations.

The key is how to use the Internet to nip the problems in the bud, not by trying to “paper over” the problem with online reputation building services but by actually improving the quality of care and making the quality of care more transparent.

DrScore does both these things.  First, by giving doctors an easy, low cost way to get detailed feedback, DrScore gives doctors the information they need to do what they want to do, to give every patient a truly outstanding medical experience.  In addition, by making doctors’ overall scores transparent to the public, DrScore lets patients see a more representative picture of U.S. medical care.

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I recently returned from a trip to a national medical meeting at which I was invited to speak in a session titled, “Managing Your Online Reputation.”  The first guest speaker talked about personal experiences of being skewered online, and the second speaker talked about doctor rating sites in general and how those sites are a jungle of mean-spirited, libelous trashing of physicians.  Worse yet, the audience had come expecting that kind of discussion about online sites and desperately wanted to know what could be done to put an end to online doctor rating.

Now that’s my kind of audience!  I’m not someone who wants to preach to the choir.

My presentation went very well.  I started by explaining why I, a doctor, would start an online doctor rating site. I explained  the value of getting feedback from patients and described how that feedback has made me a better doctor. I also demonstrated how transparency actually helps improve doctors’ reputations in the community.

I think I won over most — if not all the doctors — to the idea that DrScore does online rating the right way and is a positive development for both patients and their doctors.  (At least I know I convinced those doctors who came up afterward to tell me what they thought of the talk.)  Some of the doctors who attended the session decided to sign up to use the DrScore.com patient satisfaction reporting service as a way to get feedback from their patients.

It is heartening to know that doctors can see the value in getting patient feedback and that at DrScore we’ve created an easyk inexpensive way for doctors to get that feedback as a tool to assist them in improving patient satisfaction.

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One of the big efforts to improve the quality of medical care in the United States is the implementation of electronic health records. By putting our medical charts into electronic media, doctors will have more uniform access to our health histories, can be given ticklers for important screening tests, and can be told of potential drug interactions with medicines that were prescribed by other doctors, along with many other potential benefits. You can learn more about the advantages [and disadvantages] of electronic health records on my Getting Better Health Care radio program: “Will the electronic medical record revolutionize health care?.

These benefits may help improve patient satisfaction, too.

However, electronic health records have the potential to negatively impact patients’ medical experiences.  DrScore.com research has shown that the No. 1 factor that drives patients’ satisfaction with their doctors is the patient knowing he or she is seeing a friendly, caring doctor.  If patients find their doctors buried in a computer screen, punching buttons and typing, it could take away from the sense that the doctor is providing the patient personal attention.

There are some things doctors can do to manage the situation.

  • First, don’t put the computer on one side of the doctor’s chair and the patient on the other.  If you do place things that way, the doctor has to  turn their back to the patient to see the chart, and that is simply not good for patients’ impressions of their doctor.  I know, because that’s how things are arranged in my new office!
  • The other thing that doctors can do, especially if their office is like mine, is to acknowledge the problem to the patient. Tell the patient, “These new electronic health records are helpful in so many ways, but one thing I don’t like about them is that I have to turn my back to you to look at your chart.  I hope you will understand and don’t mind.”  Comments like these let patients clearly know that they are being seen by a physician that cares about them and about their feelings.  Letting patients in on one of these little secrets about medical office functioning also lets them feel like they are a part of the process. And they are part of the process — they are the very center of it.

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In a discussion with doctors on the value of online rating, some doctors expressed the very reasonable concern that anonymous online ratings let people trash their doctor and their doctor’s reputation.  Doing that, some doctors said, is completely unfair, especially since patient confidentiality rules completely preclude doctors from responding.  There is a lot of merit to that thinking.
One doctor suggested that patients should be required to give their name when posting online, saying, “If I had something bad to say about a doctor, I’d be more reluctant to say it if I had to identify myself.”

That doctor is, in my opinion, absolutely right. HOWEVER, that is why DrScore makes the doctor rating process anonymous.

Doctors need patients to feel completely open to giving their doctors both positive and negative feedback on their medical experiences.  The negative feedback is a gift, truly a gift — one doctor I know called it a “teachable moment” — that we doctors can use to make our patients’ medical care experiences better.  I know it has for me.

It’s a scary prospect for some doctors, the thought that we should do everything we can to encourage patients — happy or unhappy — to give us online feedback.  But it should not be scary.  Doctors are so committed to and good at giving their patients great medical care that doctors with 10 or more ratings have average scores that are well over 9 out of 10.  The fact that so many people love their doctors should make it much easier and more palatable for us to accept the negative criticisms when they come.

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A very nice blog post described the difficulty in getting some doctors to recognize the importance of measuring patients’ satisfaction.  The blog post differentiated patient satisfaction from “clinical quality.”

While the blog post was right on the mark in many ways, differentiating patient satisfaction from quality of care may be a mistake.  Patient satisfaction is a critical dimension of the quality of medical care.  Sure, making the right diagnosis and prescribing the right treatment are essential elements of good medical care, but patient satisfaction is an essential element as well.  To achieve great medical care, patients must feel cared for.  The way to find out if that’s being achieved is to ask them.

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The FDA has announced a new program to help doctors check the approved indications and other information in drug “labels.”  These “labels” are the FDA-approved educational information sheets that drug companies package with medication. See information below:

Online Service Enables Physicians To Check FDA-Approved Medication Labeling Via EHRs.

Healthcare IT News (1/27, Merrill) reported that to “boost drug safety, a new online service has been launched that allows doctors to check the FDA -approved labeling for the most commonly prescribed drugs.” The service is part “of a new campaign” called “Know the Label,” which is being “launched in concert with the FDA’s efforts to provide up-to-date and complete prescribing information to physicians.” It is being delivered to all US physicians and providers “electronically via the websites of PDR Network, The Doctors Company and other liability carriers, via EHR systems. … ‘We congratulate The Doctors Company and PDR Network for finding a practical and novel way for physicians to access the full updated labeling through electronic means and have it available at the point of prescribing,'” said Janet Woodcock, MD, Director of FDA’s Center for Drug Evaluation and Research.

I doubt this new program to disseminate the label information is going to help patients much.  At least in my field, use of medication is based on  patients’ individual conditions and results of studies that go far beyond what’s in the FDA-approved “label.”  Medications are used for conditions other than FDA-approved uses.  Different doses are used.  Combinations that the FDA-approved label says are bad may often be exactly what a patient needs. I guess it won’t hurt to give doctors the information on FDA-approved medication labeling, unless it discourages doctors from giving patients needed treatments for unapproved conditions.

For best results, a doctor’s  good judgment is the best guide to treatment.

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