Response to doctor reviews

Published on May 1, 2008

Angie's List members are loud and clear that they want the option to rate health care providers. In a recent online poll, 76 percent say they think our new initiative to rate doctors, pharmacies, insurance companies and other health care professionals is a good idea.

Dick Manion, a retired city councilman in Grovetown, Ga., offers a common response. "It's not any different than a good plumber but could be of life-saving importance," he says. "It will cause doctors to come out in the daylight, so to speak. Pharmacies and insurance companies need to be held accountable."

Just 14 percent of members answering the online poll are on the fence about Angie's List grading health care and 10 percent think we should stick solely to home-service reviews.

Attorney Jim Lager, a member in Washington, D.C., is among those against them. "There are too many variables to be able to assess the quality of health care delivered," he says. "It's relatively easy to assess whether a plumber has done his or her job correctly, but the failure of medical treatment in a particular case may not be attributable to the physician or facility."

Some health care providers feel the same way. The American Medical Association didn't return several calls requesting comment on Angie's List health care grades, but president-elect Dr. Nancy Nielsen has reportedly questioned the fairness of online ratings in general, saying they can ruin doctors' reputations and destroy trust. "[Ratings] should be taken with a grain of salt and should certainly not be a patient's sole source of information when looking for a new physician," she wrote in a recent e-mail to The Washington Post.

Some medical professionals also question whether patients have the ability to determine whether providers' care is high quality - or not. "I don't think that the average patient is medically educated enough to fairly judge a medical professional's practice," says Pat Burger, a member and registered nurse in Hilliard, Ohio.

"While these websites rate the experience that a patient has," adds Dr. Jon Marhenke, president of the Indiana State Medical Association, "they do not necessarily rate the quality of care provided."

Others worry about being able to defend themselves. "The nightmare scenario [would be] dealing with a patient who is publicly disclosing selective details of his case,"says WWilliam Lauretti, assistant professor of Chiropractic Clinical Sciences at New York Chiropractic College in Seneca Falls. "And even if I know the details are inaccurate or biased, I can't disclose my version without violating patient confidentiality laws."

For every medical professional who has come out against health care ratings, however, there seems to be another in favor of them. Dr. Vail Reese, a San Francisco-based dermatologist, says online ratings have helped him improve his practice. "If there's some facet of my practice that I can adjust, such as a staff issue or a long waiting time, reviews that mention the issue provide incentive for change," Reese says. "I think [ratings] are a great idea. The trick is getting people to participate."

Donald Bonney, chiropractor and founder of the Accident &Pain Center in Albuquerque, N.M., says a well-educated patient is the best kind to have. "A more engaged and educated patient will have a better outcome," Bonney says.

Tim Cavanaugh, a physician assistant in Mount Laurel, N.J., believes greater accountability will make professionals give more thought to their work. "I think ratings are an awesome idea," Cavanaugh says. "It'll keep doctors on their toes. Maybe it'll make practitioners think, 'Hey, this is another human being sitting next to me and not just another medical case.'"

Several hospitals and health insurance providers, many of which are establishing their own rating systems, told Angie's List Magazine they welcome the consumer scrutiny. "Swedish fully supports the movement to provide more timely and reliable information to consumers about all aspects of health care - including costs - to help patients make better, more informed health-care decisions," says Ed Boyle, spokesperson for Swedish Medical Center in Seattle.

Jeff Blunt, spokesperson for Humana, the health benefits company, says transparency and an increased focus on customer service is sorely needed in his industry. "The consumer hasn't really had a voice on customer service the way they have in other industries," he says. "Strengthening the consumers' voice to praise good service and shine a light on poor service will help change that."Whether they applaud or condemn health care ratings, these professionals agree they represent a seismic shift in the patient/doctor relationship. "[Patients] have been socialized for decades and decades not to ask questions and not to think about how doctors might be different from each other," says Art Levin, director of the Center for Medical Consumers. "But that's changing. They no longer just say, 'I trust my doctor and I'll do what they say.'"

However, Dr. Peter Lund, president of the Pennsylvania Medical Society says doctors are patients, too: "What we want for us is what we want for our patients: safe, high-quality health care."

- reporting by Amy Mastin, Brittany Paris and Paul Pogue