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Posted on 3. December 2010

How Does Your Doctor Rate?

By Kris McFalls

Thanks in large part to the Internet, there is a consumer rating system for just about any product or service you wish to purchase.  Consumers can quickly increase profits or torpedo a business into submission with a few simple strokes of the keyboard. The current economic climate and the ever skyrocketing costs of healthcare, have made rating doctors particularly popular. Everyone, it seems, wants to rate doctors — supposedly on the premise of improving quality of care. The simple truth is, however, that although some of the doctors deserve the feedback, be it good or bad, many rating systems are really about the all mighty dollar and have little to do with quality of care.

Insurance companies want to rate doctors based on how many tests they order; the more tests, the lower the rating. Malpractice attorneys want to rate doctors based on how many tests they don’t order; the fewer the tests, the higher the lawsuit. Hospitals rate doctors by the number of patients they can squeeze into their schedules. Government wants to rate doctors by getting them to prescribe cheaper drugs and correlate that with improved care. Many online rating systems rate doctors based on unverified, anonymous comments, and then charge a subscription fee for access to the content. Other rating systems that give awards to doctors have, in some cases, been criticized for being more of a popularity contest than a contest based on skill and patient satisfaction. And, while these are very broadly based statements that don’t tell the whole story, the simple truth is: The only people who have little or no say in how they are rated are the doctors themselves!

It’s understandable and wise for patients to check out doctors before they agree to spend hundreds of dollars for a few moments with someone who could greatly impact their quality of life. But, it’s nearly impossible to conduct an Internet search using a doctor’s name without a multitude of doctor rating sites popping up. In fact, it’s difficult to conduct any Internet search at all without first weeding through all of the sites that pay for prime search engine placement. Internet searches have largely become one massive ad campaign where the prize goes to the highest bidder. Like an auction, treasures can be found; but the Internet is a place where searchers need to beware in order to avoid buyer’s remorse. 

Many doctors vehemently oppose Internet-based rating systems. In response, some doctors now require patients to sign a waiver promising they won’t post comments about them or their treatment on websites. If patients refuse to sign the waiver, they can be refused service. Recently, 35,000 doctors in California withdrew their participation from Blue Shield’s new blue ribbon rating system. The doctors did this because they felt they lacked control of many of the factors used in the rating system. In July 2010, the American Medical Association sent a letter to several major insurers protesting those carriers efforts to steer patients towards their preferred list of doctors that insurers claim give the best care for the lowest cost.

Healthcare consumers have a right to transparency, especially when deciding how to best spend their precious resources to maximize their healthcare outcomes. Doctors have a right to not have their reputation ruined by unscrupulous agencies they have no connection with or patients who have received good care but still blame them for a bad outcome. Obviously, these new rating systems need a lot of tweaking before any of them can be considered reliable when it comes to healthcare. Regardless, if there was not a demand, there would not be a market. So, it seems at this point, rating systems are not going anywhere anytime soon. Therefore, patients need to do what they have always done: Take what others say with a grain of salt, do your homework and judge for yourself.

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Categories: Need to Know

Comments (9) -

Penny
10:52 AM on Friday, December 03, 2010

Your blogs just keep getting better and better.  Even Childcare is going to a star rating system in Arizona.  Good/Bad deal, with much the same questions/outcomes as you listed above.  LYT's

Nancy Nicholas
12:38 PM on Friday, December 03, 2010

Dr. James Jin, Elkhart, In is a doctor who is not on an ego trip. He is open to hearing the information I bring to my appointments. He is open to suggestions, changes and the 'new' ideas of treatment.

I am his only SubQ patient and he is very agreeable to the information I bring forth from the IDF and other sites. He is open to change!!!

Suzan Rhodes
2:49 PM on Friday, December 03, 2010

Well i have to say my immunologist Dr. Michael Volz in colorado, and Dr. Martin Mcdermott my pcp also in colorado, They have a lot of knowledge, and if they don't have an answer they will tell you , and say to me we can find the answers together. I have been with both of these doctors since moving to colorado from kansas in 1996. I worry about when they leave their practice who i will find . like when they retire or what ever. But these two are blessing from god, they spend time with you and try to answer all your questions. I always fear i overwhelm them with my many health issues, but they don't let it show if it does. They show concern if something shows up on my test results. I have a few others chriopractor, who is good, and hematologist, and other specialists who are good too. Colorado does have good docs.

Alexis Lewis
9:17 PM on Friday, December 03, 2010

I have a great pulmonologist in St. Joseph,Mo who first diagnosed me. She then referred me to KCMO to Dr. Daniel Stetchulte. He is wonderful, unfortunately I have had a relapse, the first major setback in 3 yrs, and was told by another physician in the practice that my IG level was high enough that I "shouldn't" have an infection. Well, the truth of the matter is I have been ill since October, off work, feeling crappy, but some improvement weekly albeit SLOW. My initial diagnosis of CVID came after being treated for multiple episodes of sinusitis and pneumonia along with Sjogren's symptoms (esp. dry mouth), hypothyroidism, renal tubular acidosis, hypertension, tachycardia, and osteoarthritis, all of course being treated with medication...more drugs. But having a great team caring for you and having this resource does provide comfort and unnderstanding people who truly get it. All of us would choose not to be ill, but my perspective is that no matter how ill I am at times, there are others who are worse and I thank God daily for all the blessings he has bestowed on me. I would highly recommend the immunology group at KU Med Ctr. Being a healthcare provider myself, I know that a good bedside manner may skew a patient's view of how knowledgeable and "good" a provider is, but most of us who are being treated at this level have reached a truly "good" provider and I am so thankful to have a diagnosis after 15+ years of being treated for repeated infections and asthma. The curse of a baffling, underdiagnosed, relatively "new" condition.

Shauna
10:40 PM on Friday, December 03, 2010

As the mother of a doctor, this blog made me a little cold and scared.  I see how hard he works and the stress associated with his job.  I watch the effect on his wife and small children with long hours away from home.  I know how hard he tries to be the very best he can be.  I have to say that it would be difficult to see this spoiled by someone's careless comment or a negative outcome because a patient was unwilling to do their part in the healing process. I agree that doctors need to be held accountable, but I also believe that a serious dose of caution is necessary in the rating systems.

Brian Erlandson
12:37 AM on Saturday, December 04, 2010

I started out with a terrible doc.  She was clueless unless I told her myself.  She prescribed 1/2 the IVIG I should have been given, guess those pesky math skills weren't important to her.  Even the pharmacist didn't catch it.  Inexcusable in my book.  Her staff of nurses in the infusion center were poorly trained and didn't have a clue how to mix the product or what saline to use.  Really simple stuff.  

My new doc is ten times more busy, but takes the time for me.  In addition to seeing him twice per month, he actually gets on the phone and gets immunologists to consult with him as we don't have any here in Montana.  He has called the Model center and gotten referrals and has studied my immune deficiency so he is fully up to date on the latest.  He even asked for a copy of IG Living to be delivered to his home instead of the office so he could actually study the articles undisturbed.  Now that is dedication!  He is even $25.00 bucks cheaper than the other doc.  

I worry what I will do should he decide to move or retire.  He is an oncologist - hematologist by trade and has a huge number of cancer patients.  He is the only one of those for 70 miles in any direction also.  He works insane hours and should he get sick, then there is nobody to step in for him.  How the man keeps on is beyond me.  

Lynne
10:16 PM on Tuesday, December 07, 2010

If anyone would know about quality care and how
to find it, it would be Kris.
I found the Mom's network to be the best. Call 10 friends and see hwho they go to and then see what Dr. got the most votes from your friends. Never be afraid to interview a Doctor. As the article pointed out, thes individuals will be holding your life in their hands. YOU are the comsumer, be wise.

susan watkins
6:50 AM on Friday, January 07, 2011

I am now 61 years old and received my diagnosis about 2 years ago.  Through the years I probably visited with over 100 doctors and none of them suggested an immune problem might be part of my escalating troubles.  It wasn't until I wasted down to 90 pounds (I am 5'8') and was surely dying, until I went back to my internist, hesitantly, to beg one more time requesting that she run a few 'magic' tests.  My brother came across the country to visit with me for support.  By that point all of my doctors had given up and agreed it was all 'stress related' and that I needed psycho therapy... which incidentally, I had been getting for the last 2 years at 150 a visit, twice a week with no results, just more drugs.(spent easily 10 thousand out of pocket) Lithium, seroquel, major, major drugs.  I was told I was bi-polar and overly stressed.  I argued vehemently, switched doctors and they all seemed to agree.  I was almost beginning to believe the crap myself.  By the time my brother came he was horrified at my deterioration, but was too kind to say much.  I told him that my only hope was to go back to my original doctor (whom I wasn't speaking to anymore, which is totally not my personality) and beg.  He agreed to back me up.  

We sat in silence waiting for her.  I was saving all my precious energy for my audience.  Finally, she came in and was immediately on her best behavior since my brother was in the room.  They spoke cordially, and then she explained to him the usual crap.  He asked a couple of questions and she responded accordingly.  I should be exercising she told him.  Join a gym.  ARE YOU KIDDING ME?  I'M DYING.  As I sunk deeper into my chair trying to disappear, I finally heard my brother raising his voice slightly and speaking in a more authorative way, 'Well, my sister is convinced that this is not stress and there is something else going on.  Something real, something that must have a pathology.'  My doctor tried to persuade him by claiming that I had seen every kind of doctor and had all of the testing done and that nothing could be found.  At this point I was sobbing in fear that once again nothing would be done.  My brother kindly remarked, 'well you can't have performed every test because she is still dying.  Look at her.  I believe her when she tells me something is being missed.'  My doctor sat and looked like she might be thinking, and said, 'well, there is one more blood test I could run, but it's a long shot'.  I quietly murmured through my tears, 'please do it before I die'.  3 days later we had the results and the door opened into my new world.

I WAS VINDICATED.  Even if I died at that point, I didn't much care because no doctor or nurse could look down at me anymore and hopefully I could put a stop to the robbery.  The doctors and nurses at my local ER had officially labeled me as 'col' CRAZY OLD LADY.

Everyone knows the rest, that's just how I got there.  My brother saved me.  With his cool demeanor and commanding presence, he broke through in a way that I couldn't.  I have been a successful business woman and earned respect in my community, but I was in a new State and knew no one and for whatever reason could not break through.  I am beginning to think that the hallmark of this disorder should read, 'one may face years of misdiagnosis, financial hardship even worse, loss of identity, the crushing of a cheerful and positive attitude, acute loneliness and isolation, fear, hospitalizations with no diagnosis, and even death, until finally receiving the ultimate gift, your diagnosis.  After all of that, you have just begun your real fight.

Kathy Zabliski
10:53 PM on Friday, January 21, 2011

I have been an RN for over 20 years and a major health care patient for 8.  I have seen both sides of this issue.  I truly believe that there should be a non-partial universal web site where patients can log in with their information and rate hospitals, doctors, nursing care, chiropractors, dentists.....

I believe that patients commenting should sign an information sheet about the seriousness of their rating & remarks, and provide information for follow up if necessary.

I believe that the health care professionals should have the right to respond to remarks good or bad.

I think patients, as a whole, would rate health care professionals honestly.  I understand that some doctors work very hard and dedicate their lives to their work.  There, unfortunately, are getting too many of the exact opposite.  People have a right to know which type of doc they are getting.

It's taken me a few years, and trying out different doctors to find the right ones.  I DEFINITELY would NOT recommend some because they were rude & arrogant.  The ones I have now are saints.  I am treated as an intelligent human being.  They listen.  I would like to share the information that I have learned to help others in finding the right doctor.  It just might make it easier for someone else to find a doctor.

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