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Posts Tagged ‘drscore.com’

One of the issues with online doctor rating sites is that it is very much a one-sided affair.  In other businesses, if a customer made a complaint online, the business would be able to respond.  Not so on doctor ratings sites.  The patient privacy rules in the HIPAA legislation  preclude physicians from even acknowledging someone is their patient, so physicians have no ability to respond if they feel there is an inaccurate post about the care they offer.

This seems unfair to many physicians, and I do agree.  Fortunately, the vast, vast majority of patients are very, very happy with their doctors and their care.

The unlevel playing field problem is exacerbated by the possibility that someone with a personal grudge against a physician could purposefully try to harm the physician’s reputation.  It could be a competitor, an angry former spouse or a patient who felt vindictive for some reason.  While one advantage of an anonymous online feedback system is that it lets patients feel they can give fully open and honest feedback without risk of reprisal, anonymous systems have the potential for abuse, too.

Perhaps there could be a rules change that would let a physician respond if a patient opens the door to a discussion of the care they received. But I find that possibility to be unlikely, especially given all the benefits of strong rules about patients’ privacy.  Some physicians may consider other avenues, like those offered by Medical Justice.

But there is another approach, which  is to do what DrScore does: Don’t post open comments at all.

And actually, I think the best solution is to just get every patient to rate his or her doctor online.  That way, even if one patient does say something bad, the public can see what other patients think in order to determine if the negative comment was an outlier or was really representative of what the doctor was like.

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An August 3, 2010, article in The Washington Post discussed rating systems for doctors, pointing out that current doctor rating systems are “rudimentary” and “may not reliably reflect a doctor’s abilities.”  Well, yes and no.  When it comes to measuring technical aspects of diagnosis and treatment, there  is probably no reliable system that reflect a doctor’s abilities.  On the other hand, we have excellent systems, DrScore.com among them, that are able to reliably assess patients’ satisfaction with their care.

The Post article points out that the standard way to find a doctor is to ask friends and family members for advice or to trust a referral from another doctor.  These are very reasonable, albeit limited approaches.  Online systems that assess and report patient satisfaction are extensions of the “ask friends and family” approach.  These systems may not be a reliable measure of a doctor’s ability to make a diagnosis and prescribe an accurate treatment, but they are a reliable measure of how happy patients were with the care they received.

And that is something worth knowing.

A tremendous advantage of an online rating system like DrScore.com over the traditional friends and family approach is that the online data collection allows doctors to find out how they are doing, a critical tool to help doctors do what they want to do most — give their patients great medical care!

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Make sure you check out the Getting Better Health Care Radio Program on webtalkradio.net. My latest interview is with Dr. Nancy Oriol, founder of the award winning Family Van program in Boston. She tells us about the barriers to accessing our health care system and how reaching out to the community can help reduce those barriers.

Want to reduce your health care costs? Don’t miss my interview with Dr. Cynthia Koelker, author of 101 Ways to Save Money on Healthcare.   She tells us how we can save money on preventive care, including information on which screening tests we need and which we don’t.

The previous show with David Coates talks about the politics of making needed changes in our health care system.

Another show not to be missed is the interview with Dr. Sandra Kweder, Deputy Director of the Office of New Drugs in the FDA’s Center for Drug Evaluation and Research.  She explains what the FDA does to assure that marketed drug products are effective and safe.


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I received an e-mail invitation to attend a medical-legal seminar on reducing risks. I’m not sure what they are going to cover, but clearly, the No. 1 way to reduce medical legal risks is for doctors to give patients great quality medical care. Patients also need to perceive the quality of care is great. That is why obtaining feedback from a patient satisfaction survey service like DrScore is a necessary component to assessing and assuring patient satisfaction.

Great medical care is really a partnership. Patients can reduce their risk of being in the kind of situation that results in medico-legal liability by taking more responsibility for their own care. Patients should get a copy of their medical records, particularly the results of laboratory work that is done. That will help make certain nothing falls through the cracks in a system that has shown itself to have too many cracks.

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Doctor patient communication

The Archives of Internal Medicine reports that communication between doctors and patients isn’t always what it should be.  The study of 89 hospitalized patients found:

  • Of the 73% of patients who thought there was 1 main physician, only 18% could name the physician
  • Only 67% of the physicians thought patients knew their names
  • Only 57% of patients knew their diagnosis
  • Only 21% of physicians said they always provided explanations of some kind
  • 90% of patients getting a new medication said they were never told about any side effects

The researchers concluded that steps to improve patient-physician communication should be identified and implemented.  Boy, is that an understatement!

To start, perhaps doctors could leave each patient a business card with the doctor’s name on the card.  That would help patients know their doctors’ names.  Even better, have a line on the card where the diagnosis could be written.  I’d include the doctor’s cell phone and e-mail address to help enhance communication between the doctor and the patient and their family.  And perhaps the doctor ought to have a checklist of things to do so that whenever a new prescription is given, the patient is given a written explanation about the medication, including the potential side effects to look out for.

Of course it would help for every patient to be given the opportunity to give their doctor feedback through a system like www.DrScore.com to identify these kinds of problems and solutions to them ASAP.  A “Please give me feedback at http://www.DrScore.com” would be a nice addition to that business card.

We are so invested in improving medical care, with billions and billions of dollars going to the development of new treatments that may someday help someone.  Just a little common sense and some inexpensive solutions could be done right now to enhance the care that most patients receive.

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The AMA and 47 state medical societies authored a letter to insurers about the unreliability of “claims-based” doctor ratings. Claims-based studies use the billing information doctors send to insurers to assess the quality of the care that is delivered. The AMA letter cited studies by the RAND Corporation showing the limitations of these studies.

The AMA hasn’t offered a better way to assess the quality of care doctors provide. Measuring the quality of medical services that doctors provide is extremely complicated, especially because we want doctors to tailor treatments to each patients’ specific needs, preferences and desires.

One aspect of medical care that may be most easily measured is patient satisfaction. This is what we measure and report at DrScore.com.

Patients always know how satisfied they were with their experiences, and there’s growing recognition of the value of patient satisfaction measurement. Government reimbursement programs covering health care may soon require patient satisfaction measurement. The medical boards that certify physicians may require doctors to document and report results of patient satisfaction surveys, too.

This is good news for doctors. Doctors give patients great medical care, and open reporting of that quality is bound to help the public see what a good job physicians are doing.

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A story about a horrible killing in Oakland, Calif., caught my attention. The shooting of a young man by a security guard was captured on tape. The reaction of the community has been national news. This event also received National Public Radio (NPR) coverage in relation to state regulations on videotaping police.  Some states have made it a crime to videotape police in action.

One Web site is devoted to publishing such videotapes. The creator of the Web site was asked on the NPR program about how often the site shows videos in which the police are seen in a good light. He said that rarely happens, but he acknowledges the site isn’t designed to encourage the posting of videos that support the police side of the story. A caller to the program, the executive director of the Massachusetts Police Association was supportive of the public videotaping police officers, pointing out that most of the time such video would be supportive of police.

The police video issue shows the effects of selection bias, a very common problem. When a site like carlosmiller.com solicits video that shows police in a poor light, the site doesn’t provide a representative sample of what’s really going on. Front page news stories about doctors (or about anything else) are similarly biased toward bad events. Even doctor ratings sites can be biased, particularly those that call only for submissions of problems.

What people need is all representative information, good and bad, in order to make well-informed judgments. At DrScore, we encourage all patients to give their doctors feedback, and we encourage doctors to ask their patients — all their patients, the happy ones and, especially, the unhappy ones — to give feedback too.

Getting feedback that tells us how we can do a better job is, after all, a huge gift.

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