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Posts Tagged ‘transparency’

One of the benefits of online doctor rating — a benefit to patients and doctors — is a transparency of medical care quality that will help people identify the bad doctors, the uncaring ones, the ones who, according to some patients, you wouldn’t send your dog to. Patients aren’t the only ones who know about these doctors.  Doctors know about them too. They have seen patients who were seen by these colleagues, and all of those patients were unhappy with the care they received.

I know that online doctor rating isn’t going to find many such doctors.  In fact, quite the opposite, online rating of physicians is going to show there aren’t nearly so many “bad doctors” out there as people think there are. Let me explain.

I’m a practicing dermatologist.  I see patients who have seen another dermatologist in town, maybe a dozen or so of that doctor’s patients.  Every one of those patients was unhappy with the care they received, and none of those patients received treatment that cured their condition.

Now that’s clear evidence the other dermatologist didn’t know what they were doing, right?

No, not right.  You see, every time that other dermatologist clears up his or her patient’s rash and gives his or her patient a medical care experience the patient is happy with, that patient continues seeing the other dermatologist and doesn’t come see me.  I  see that doctor’s outliers, the occasional patient who, for whatever reason, didn’t get better or who was unhappy.  I’m sure that the other dermatologist sees a few of my former patients too, only the ones whom I didn’t cure, only the ones who were unhappy with me.  Our observations give us a misleading picture of other people.

Well what about those doctors whose patients post comments like, “I wouldn’t send my dog to that doctor?”  That kind of comment does happen, and, sadly, I’m sure that’s the true opinion of the patient who makes that comment.  But those comments are generally not anywhere close to representative of what the vast majority of that doctor’s patients think.  I get comments like that at times (thankfully less often than I used to, having learned from patient satisfaction feedback what I was doing wrong).  I’ve been rated over 500 times on DrScore.com.  The average of those scores is 9.1 out of 10 (not bad, according to my mom).  Still, occasional patients give me a 0 or a 1 for their experience.  I know they may think everyone gives me a 0 or 1, that I’m a “bad doctor,” but the great majority of my patients think I’m a 9 or 10.  So far, that’s true for all the doctors with just 10 or more ratings on DrScore.

There may be “bad doctors” out there, but I suspect they are incredibly rare.  There weren’t any in my medical school class, and I have yet to meet one in person.  If there are any, I hope we do smoke them out with online ratings.  If they exist, maybe the online scrutiny will wake them up to the need to improve the quality of care they offer.

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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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DrScore has shown time and again that doctors’ conventional wisdom about doctor rating — that only unhappy patients will rate their doctors online — is completely wrong.  The most common overall satisfaction score that patients give their doctors is a perfect 10.  The next most common score is 9.  Of doctors with 10 or more ratings, the average score is just over 9.3 out of 10.  And if a doctor wants to make the annual “America’s Most Loved Health Care Providers” in the United States, he or she will have to have a score well over 9.9 out of 10.

So. if so many people are so thoroughly happy with their doctors, why do we need online doctor rating at all?
First, the public wants to know (and doctors need the public to know) how well doctors are doing.  The newspaper is never going to publish a front page news story with a title like, “John Smith Sees Dr. Jones and Has a Wonderful Office Visit.”  No, if the newspaper publishes a front-page story about a doctor, It is most likely negative, leading people’s perceptions about quality of care to get quite warped.

Transparency is good for medicine.
Second, getting feedback from patients online is easy, efficient and helps doctors do what doctors want to do most: give patients great care. DrScore’s interactive survey makes it possible for doctors to get the detailed feedback they need — both positive and negative criticism —t o make their medical practice better from patients’ perspectives.

In all honesty, I don’t think Nordstrom’s or Disney would be happy with a score of just 9 out of 10, with one in 10 or one in 20 customers being distressed with their experience.  We in medicine can — and should — be aiming higher, trying to give all patients what they consider a perfect, caring medical experience.

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A simple solution — greater transparency for all.

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An e-mail arrived from a marketer offering to help market my medical practice.  The message talked about how the Internet can be good or bad, how doctor rating websites can negatively affect a practice, and how this marketer has solutions for how to put the Internet to better use.

I have a solution, and it’s really quite simple.  Doctors should be encouraging their patients to do online ratings.  Doctors are doing a great job for their patients.  What doctors need is transparency: We ought to encourage patients to do online ratings so that the public sees the great quality of care that doctors are providing.

On the DrScore.com rating site, the average score of a doctor with 20 or more ratings is 9.3 out of 10!  There’s no reason to want to hide that.

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A few key messages about online doctor ratings at DrScore.com.

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Economist Gerald Epstein found that economists who have been advising government have had financial ties to the entities about which they had been giving advice.  Sounds a bit seedy. He found that one prominent economist had written a supportive paper about Iceland’s economy — funded by the Icelandic Chamber of Commerce — shortly before that economy tanked (the economist responded at this site.

Epstein didn’t claim there were abuses; he just pointed out that it would be good to have some ethical guidelines in place, particularly disclosure of financial ties and more transparency, just as we are seeing in medicine today.  Here, here!  Transparency is good for all concerned, something we strongly believe in at DrScore.com.

One of the best points Epstein made is that he didn’t believe that economists should cut off ties with industry.  Those ties could be important, just as in medicine it is valuable for drug companies, government agencies, academic centers and doctors to work together to develop and disseminate new treatments (something discussed on Getting Better Health Care a few months ago).  But ties should be transparent, so that patients can made informed decisions.

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