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The Pros and Cons of Rating Doctors

Why online reviews of physicians get mixed reviews

When editors of Consumer Reports rate cars or refrigerators, potential buyers get sophisticated advice from engineers and technical people who know what they are doing. But when patients evaluate physicians, it’s another matter altogether.

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Aside from purely objective material (location, education, specialty), the information readers get on physician rating sites is mostly useless, critics say. One major drawback: too few ratings. Indeed, there is widespread agreement that the more ratings posted about a doctor, the more accurate the picture of the physician’s performance.

Some physicians are so incensed by what they call the unfairness of the ratings that they are asking patients to sign waivers — critics call them gag orders — promising not to post any reviews. And a few doctors reportedly give bribes or discounts for good reviews.

Yet physician ratings could turn out to be even more important than user ratings for the latest coffeemaker or family car.

As medical consumers, we want the best care for our money. In addition, experts say, health insurance carriers want the best physicians delivering the most efficient care at the lowest cost. And physicians themselves want to know about other physicians, how they’re handling swelling streams of patients and what those patients think of them.

More websites rating doctors

Accordingly, the list-makers who rate physicians are arming to do battle — meaning, in their argot, to grab eyeballs, advertisers or even fees. The biggest players are Angie’s List, RateMDs, HealthGrades, Vitals and Vimo.

In all, there are more than 30 sites that compile patient opinions in various formats and put them on display, according to a 2008 report by Ruth Given, an independent health economist and analyst for many Internet companies.

But each site is far from perfect. Because the sites are relatively new, most doctors have just a few postings, and it’s rare to see a physician with more than 100 comments. Moreover, consumer groups worry that people searching for valid, reliable assessments of doctors too often find only highly personal, emotional opinions —  from angry rants to fulsome praise.

Are the comments fair?

The American Medical Association contends that these ratings should be viewed with healthy skepticism because the comments are subjective and not statistically valid. “The downside of the Internet is that things are so instantaneous, you can put something down very quickly, and it may not be exactly what you’d want to say in the light of day,” says AMA president James Rohack.

One of the few online enterprises taking an organized, scientific approach to doctor ratings is the one organized by Robert Krughoff of Washington, D.C. , who says he is trying to set up a system that’s fair to doctors and helpful to patients. A lawyer and an old hand at delivering consumer information, Krughoff is the founder of the Center for the Study of Services. He publishes the service-rating magazine Consumers’ Checkbook in several U.S. cities; the publication accepts no advertising and is supported by fees from subscribers. Not long ago he told Family Practice News, a trade publication that goes to 70,000 physicians: “Outcomes are much more difficult to measure in health care. Consumers know right away if the plumber is good. With a health care provider, they may not know until five or 10 years out.”

Next: A better way to evaluate docs? >>

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