Physicians who know about RateMDs are rarely neutral about it. Physicians who don't know about RateMDs... well, watch out, docs!
RateMDs is an online information exchange where anyone can anonymously post comments about a (North American) physician. There are similar sites for rating lawyers, high school teachers, university profs, etc.
RateMDs sparked my online patient satisfaction survey. Here's why:
Physician rating sites have existed as long as there have been physicians. These sites used to be called coffee row, the backyard fence, and your cousin's friend who knows someone who knows someone. The information was there, but was informal and relatively inaccessible unless you were "connected". Now, the Internet makes everyone connected, and they're sharing information.
Browse through RateMDs (c'mon, you know you want to), and you'll see why some physicians are upset about being rated. There are some pretty frank comments. Some may be accurate and deserved. Others may be vindictive and slanderous. We have no way of knowing. Perhaps looking at the pattern of comments gives a reliable picture of each physician's demeanor. I'd like to think so, but comments and ratings for individual physicians vary quite widely in some cases. One person with a vendetta could leave multiple posts slagging the doc. A physician could salt his own page with glowing praise.
There are weaknesses with the RateMDs model, but the idea is here to stay. I think we should embrace the idea, improve the model and turn it to the benefit of our patients. After all, what physician doesn't want honest, frank feedback on his or her performance?
Ha, ha! Of course, I'm being facetious! I'm a lot more comfortable not hearing about my weaknesses and bad habits, and I'm sure many other physicians feel the same way. If I know my performance is substandard, the logical and professional response is: try to improve. And that means... Change! Before physicians decide to ask for feedback from our patients, we need to commit to making the changes that the responses suggest.
I want to solicit patients' opinions about my performance, but I also want to draw on their experience and insight to make constructive suggestions on how I can improve. To that end, I made my own post (April 17, 2007) on RateMDs encouraging people to comment on how I can improve my medical practice.
As you see on my RateMDs page, there haven't been many responses to that request. As such, I decided to start my own personal rating service. I'm requesting patients to take a web-based survey about their experience in my office. In the spirit of openness, I'll post a link to the survey responses on my blog.
How can you be sure that I haven't polished up or even completely faked the survey results? Right now, you can't. But, I welcome any suggestions on how I could set this up so I can't be accused of fabricating results. (At the moment, I feel I need to review the responses before posting them just in case a patient has included private personal or medical information that should not become public knowledge.)
Any suggestions?
Wednesday, September 19, 2007
RateMDs: Saint or Satan?
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2 comments:
I had never heard of or visited RateMDs but you were right...once I did, I wanted to! And I did. Pretty interesting...checked out some MDs I know, some who have treated me and many who have not. Although some comments had a harsh tone I would have to say that in regard to comments about personality/demeanor I could often understand how the person making the post might arrive at their opinion. I often joke that I can count the number of times that I have received truly exceptional service from an organization or individual on the fingers of my two hands. It may be a slight exaggeration but it isn't far from truth and it applies to physicians as well. That being the case, and knowing the personalities of some of the MDs I looked up on RateMD, it doesn't surprise me when I see words like cold, aloof, distant etc.
The comments I saw about physician skills are harder to judge but more disturbing and, potentially, more damaging. Herein lies an area where we need to and should try to improve on RateMD. Personalities will always have the potential to clash and this is a subjective area. On the other hand, skills are something we can assess in a reasonably objective manner. For a start, it seems to me we need to begin systematically assessing patient outcomes and linking those to MD performance. There are well validated tools available for application to many clinical conditions. MDs and institutions have demostrated lots of reticence in this area.
While I appreciate such intiatives are complex, I think the most compelling argument for tools like RateMD is the fact that those of us who work in health care are seldom passive consumers of health services. When we need specialized health services we ask around about who we should see or where we should go. Those of us inside the system obviously do not believe that all MDs are created equal. Unless the information we share with one another and with our families is purely anecdotal we have an obligation to make the same info available more broadly. Failure to act on that obligation gives rise to tools like RateMD and all its inherent shortcomings.
As for improving on RateMD, maybe we need to create a site (if there is a business idea here I want part of the action) that has patients complete a validated outcome assessment tool relevant to their clinical problem in addition to permitting the comments re personality etc. It might (no guarantees though) produce more balanced information.
I'd be interested in knowing whether your patient survey goes beyond issues related to interpersonal skills?
Thanks, James. My survey is only looking at interpersonal issues. I like your idea of applying a validated outcome assessment tool related to the person's condition. Maybe it would be administered through and reported on by a group like a credit rating agency. (You want part of this as a business idea? It's all yours... go for it!)
Reporting on outcomes is challenging but is really what each physician-patient interaction is all about. There's an old saw about how a physician is judged by patients: Available, Affable and Able - in that order. Outcome measures would move "Able" to the top of the list.
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