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My Medical Manager

The Pros and Cons of Rating Doctors

Why online reviews of physicians get mixed reviews

While that’s still true, he says, the time is ripe to mine patients for what they do know about their physicians, and he’s out to correct what he thinks is an abominable situation in the M.D.-rating cosmos.

A better way?

In July 2009, working with health care plans UnitedHealthcare, Aetna, Cigna and regional Blue Cross and Blue Shield plans, Krughoff launched a rating site based on patient answers to questionnaires developed by the U.S. Agency for Healthcare Research and Quality, a part of the federal Department of Health and Human Services, which sets the standard for querying patients about the care they’ve gotten from physicians. The insurance companies helped him survey a random sample of their patients.

"Our members tell us they want to know which doctors give high-quality care, and which listen, explain and follow up." — John Rother, AARP’s executive vice president for policy

Krughoff’s surveys, mailed to patients who have actually seen a doctor in the past 12 months, ask questions like: “How often did this doctor listen to you carefully?” “How often did this doctor explain things in a way that was easy to understand?” Physicians are scored based on responses. So far, Krughoff’s new, free physician ratings are available only in three metro areas — Denver, Kansas City, Mo., and Memphis, Tenn. But he intends to expand quickly to New York and other major communities.

The gold standard

The kind of information Krughoff’s patient surveys provide, AARP and other consumer groups say, is the gold standard.

“Our members tell us they want to know which doctors give high-quality care, and which listen, explain and follow up,” says John Rother, AARP’s executive vice president for policy. “We want this kind of solid information from patients to be publicly available because it can lead to better-informed decisions.”

Krughoff’s Checkbook website for Kansas City now has information on 710 primary care doctors, based on an average of 58 completed surveys for each doctor. He says his competitor Angie’s List “doesn’t have a single individual primary care doctor with more than eight ratings.”

Plumbers, contractors, doctors

Executives of Angie’s List, known for 14 years as a rater of local plumbers and contractors, say they’ve been in the physician rating business only a short time. Mike Rutz, the list’s vice president of health care services, says, “We’re getting there.” Many respondents are simply patients — among the 750,000 monthly subscribers to the list — who write voluntarily about their experiences and aren’t likely to be negative.

A large number of physicians get A’s on Angie’s List’s letter-based grading system. But there are a few clunkers. It took Indianapolis resident Jo Ann Klooz a year, after an unhappy encounter with a specialist, to complain about his behavior at a difficult moment. Klooz says the doctor checked his watch impatiently as her 10 brothers and sisters assembled to decide whether to take their 70-year-old father off a respirator. Finally, Klooz decided to post her feelings on Angie’s List. Klooz accused the doctor of being “unprofessional and insensitive.” “I gave him an F,” she says.

Rutz says Angie’s List collects 10,000 reports a month about patient experiences with physicians. “The majority of our reports come through our website and our call center” he says. “We also send periodic outbound e-mails and phone calls to our members to ask them if they have any reports or experiences they want to share with us. It’s a truly valuable activity that keeps the members engaged and really enhances that sense of community that comes with being a member.”

While a few sites are member-supported, says economist Given, most, like RateMDs, get their money from advertising. All the comments are anonymous, and doctors aren’t flagged when they initially appear on the site, even if the comments attack a doctor’s reputation.

Next: A doctor's view of the ratings sites. >>

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