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The Search for a Five-Star Doc

Jay Moore, for HealthLeaders Media, February 25, 2009

When you're planning a vacation and thinking of trying some pricey restaurant with a celebrity chef's name on the door while you're there, do you hop online to find some consumer reviews first? I do. Sure, you have to keep such reviews in perspective—no matter how good a restaurant might be, someone's not going to like it—but as long as most people offer a positive assessment, I figure the place must serve some decent grub. While I'm at it, I might search for reviews of my hotel, too. Or that museum I want to visit. Consumer reviews might have their limitations, but they also have their value, if you know how to use them.

At least when it comes to finding a golf course or a place to eat pancakes. But what about finding a physician? The health insurer WellPoint's deal with Zagat to have WellPoint members rate their doctors online has garnered a fair amount of press, but in case you need a primer: The reviews include WellPoint members' ratings of their physicians in four categories—trust, communication, availability, and cost. As with other Zagat guides, patients' ratings are summarized and displayed numerically; also included is the percentage of patients who recommend the doctor as well as contact information. A physician's ratings aren't posted until he or she has been rated by at least 10 people.

Now, a sizable number of physicians have been asking patients to offer online feedback in a variety of ways for some time. A sizable number of physicians also hate the idea, of course—at least in a casual form like this that seemingly likens finding good medical care to finding a good nightclub. The central theme of those who object is that while patients might report that they "like" doctors for any number of reasons, they simply aren't qualified to judge the quality of care—or as Arthur Caplan, director of the Center for Bioethics at the University of Pennsylvania, put it in a New York Times piece I read, "There is no correlation between a doctor being an inept danger to the patient and his popularity."

I agree. Just because a physician is nice or friendly or accessible or whatever other generic adjective you want to apply doesn't mean he or she is actually, you know, good. WellPoint and Zagat contend the ratings are about patient experience, not care quality. Fair enough, but I'm not sure Joe Consumer reading reviews in search of a doctor will make that distinction.

If I knew that consumers would, in fact, make that distinction, then I actually think such ratings could have value—as long as the rating categories make sense. Communication, yes. Trust, maybe. Availability? I guess some docs make a stronger effort than others to squeeze in one more patient or return phone calls in a timely manner, but I don't know that a physician should get demerits for having tons of patients and thus being "unavailable." And cost? Physicians determine the cost of medical care? I didn't know that.

Smart remarks aside, this kind of feedback certainly has its place. At some companies, for instance, subordinates rate their supervisors. On college campuses, students rate their professors. Patients' observations on, say, the amount of time spent in the waiting room or a nurse's bedside manner do have value—particularly if multiple patients offer similar viewpoints and a genuine trend emerges. But to me, that value is limited. Talk to me about outcomes data or infection rates—then I'll pick my provider.


Jay Moore is managing editor for HealthLeaders magazine. He can be reached at jmoore@healthleadersmedia.com.
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