Doctors can’t do much about negative ratings?

The AMA News published a terrific article entitled, “Negative online reviews leave doctors with little recourse.”  The article describes inappropriate practices by one doctor rating site and the privacy limitations that prevent doctors from responding to negative reviews.  It certainly isn’t a level playing field.

I’m not sure the playing field needs to be completely level, but fairness ought to be expected.  Giving patients the right to freely publish their opinions isn’t a problem.  As readers of this blog know, our DrScore research finds that patients typically love their physicians. On the DrScore.com rating site, the average score of a doctor with 20 or more ratings is 9.3 out of 10.  Online physician rating Web sites that purposely advertise for or prominently display only negative ratings aren’t being fair and aren’t giving the public what they deserve: honest, representative feedback on doctors.

Transparency is good for patients and physicians.

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Physician rating sites — I agree, the field isn’t level

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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Customer satisfaction is the same — whether it is with your doctor or your airline

When I went on my recent trip to Japan, I flew United Airlines.  The meeting sponsors paid to have me fly in business class.  It was a great experience.  I could tell how the staff and the company were committed to giving me great care.
Just before the flight ended, a representative from United came over to me and surveyed me on my experience with the flight.  He was very polite, but at the time, despite my love of giving feedback, I just wanted to watch the on-flight entertainment system.  I think they would do well to offer an online feedback system like DrScore so that I could give my feedback at a time that was most convenient for me.

Sometimes I hear physician colleagues say that patient ratings aren’t a good way to assess the quality of health care.  They have a point, but they are also missing the boat.  I have no idea how to fly an airplane, much less all the other technical aspects of how airplanes and airlines work, just as most patients probably don’t know much about the technical aspects of medical care.  But I do know and I can comment on whether my experience on my trip was good or bad.

Patients know whether they have received a good medical experience.

Safe, on-time air travel is like making the right diagnosis and giving the right treatment.  It’s a critical foundation for great service, but it isn’t the end of great service.  A caring experience is essential, too.

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