Monday, December 17, 2007
Rating your doctor
I hate going to see the doctor. I probably shouldn't admit this, but it's been almost three years since my last general checkup. In my case, it's not about the high cost of insurance (my co-pay is a reasonable $15) and not about being lectured on taking better care of myself (even though the doctor does harass me about exercising more). For me, avoiding the doctor's office is about not actually liking my doctor's personality. I don't particularly find her pleasant to be around.

You see, I've tried to find a doctor I like, but as many of you know, it's not easy. If you do manage to make an appointment with a doctor who actually accepts your insurance, you wait months to see him or her. Even after you get into the examination room, good luck spending more than five minutes with the doctor. I can't even remember the last doctor who actually remembered me from my last visit.

That's why I was so intrigued by a new service run by the restaurant review service Zagat's Survey and health insurance company WellPoint. I've been using Zagat's little burgundy books to choose my dining experiences for years. My wife and I never try a new restaurant without consulting Zagat's first. Before I sound too much like a commercial, let me tell you what I like about it. More than 300,000 people chime in on restaurants all around the world, and the establishments are rated on a 30-point scale on food, decor, service and cost. There is also a "straightforward" and "helpful" comment section that puts "well-meaning" reviewer comments in quotes (as I just did). Now, imagine the same idea of "quick and easy" reviews applied to your doctor's visit.

In the Zagat/WellPoint survey, the doctors will be rated online on trust, communication, availability and environment on a 30-point scale. There will also be a comment section after the numerical ratings. A doctor's review won't be published until he/she has 10 reviews by patients. The survey is free and for now is available only to WellPoint insurance members.

"It's not necessarily a bad idea," says Dr. James King, president of the American Academy of Family Physicians. "It's a little different choosing a doctor over the best restaurant in town. Whether you like the doctor is not indicative of whether you're not getting the best care. A patient needs to understand what's being measured and not being measured." King says communication and friendliness don't always come hand in hand with the best skill. Critics say that a potential pitfall may be any influence WellPoint may have in the survey. Other rating services by insurers may factor the cost of a patient's care into the ratings.

What do you think about rating your doctor? What would you say needs improvement at your doctor's office?
I think communication is one of the most important factors in rating a doctor. My doctor retired a few years ago and the new doctor had such a strong accent I could not understand him. He may have been a great doctor but his accent killed the deal for me so I changed doctors. The one I have now is fantastic and I can understand him.
I wouldn't trade my doctor for anything. He accepted me, when he wasn't accepting new patients. Not only me; my husband and then later, my one, two, three kids. He makes me feel like I am the most important person of the day. I can get an appoinment the same day I call if neccessary. I think everyone needs a good family doctor.
Because I have a lot of disabilities that require a lot of care I am regularly seeing tons of doctors of many different specialties.

Rating a doctor would be nice, but how would they be rated. I personally need highly competant doctors that are willing to work with rare disorders and able to do extensive research on my multiple conditions and how they might interact.

So far I have only found ONE doctor out of over 100 that I have seen that was willing and capable of even trying to do this.

Additionally, I need a doctor to be able to manage all the other specialists I see so that they work together as a team. No doctor has proven themselves capable of this.

I have to carry all my medical information around with me to each doctor visit. The summary alone takes 1/2 hour on a good day. I try to send copies of all the information in advance, but it is always lost.

I usually have to teach each new doctor how to treat me rather than them helping me with the problem that I came there for.

I lost all respect for doctors around doctor 60 that I saw in a 5 year period.
I think communication is important not only from the doctor but also what the patient relays to the doctor ! Also most importantly is for a doctor to LISTEN to your symptoms and concerns. A doctor who truly listens before interrupting a patient will be better able to diagnosis instead of ordering all kind of tests to determine the problem.
I give my doctor an A++ and I live in rural Pennsylvania.
Hi A. Chris,

Kind greetings. I hope you are feeling good get your check up soon, although it made me smile as you work with Dr. Gupta. But I sure can empathize with the hesitation of going to the doctor. Before my own crisis I had little experience with doctors visits. I could count on one hand how many times I had visited since my youth. My file only had 1 piece of paper in it.

This is such an important topic to discuss as it can end up as a life and death matter. Yes, I DO think a review would be a good idea. I sadly must agree that sometimes friendliness and compassion is just a bonus. What a patient really needs is someone that will listen.

Let me start by saying, that I truly empathize, realizing that our doctors have one of the hardest jobs in the world. I read an article that stated many doctors now suffer from COMPASSION FATIGUE. I kindly realize this.

But sometimes it is not just a bad day. One doctor in particular stands out.

I am not going to recount my long story but it changed me forever. If there was a review for him it would be the lowest one. Sadly, I am not the only patient that had this problem, as I have heard from several other patients since. Some tragic.

One girl I know was 28 years old and told him she had a lump in her breast. He scolded and dismissed her, stating she was too young to have breast cancer. End of discussion. Within less than 2 to 4 years she had a double mastectomy and was fighting for her life.

Imagine if she could have rated him? How that could help the next patient!

If I could rate him I would hopefully save someone from my painful distress too

This is the problem, if you cannot communicate your symptoms then you suffer in silence. In some situations your body can take care of itself. Life goes on. But sometimes it is more serious then that and by not receiving a proper diagnosis and subsequent treatment, you may get worse or even have permanent damage. What a needless tragedy.

I am sorry for those having a difficult time. I BEG patients to fight for good care. Try the kind approach first. Kindly tell your doctor if you feel he or she is not listening. Tell them what you need. See how they respond. It might be all that is needed. But if that does not work then we MUST find a doctor who will listen. Please do NOT give up.

I feel a rating system could save someone from a lot of pain. Life is so precious, we CANNOT let anyone cause us to waste one single second. Not one second.

And my kind advice is that if you do have a kind doctor or specialist, please send them a thank you note. They surely deserve it. Burn out is often the result of 2 things:

1. Caring too much
2. Not feeling appreciated

Our doctors and specialists deserve so much appreciation from us.

Thank you so much A. Chris, please take good care of yourself.

In appreciation, G


"As to diseases, make a habit of two things - to help, or at least, to do no harm.”

“Wherever the art of medicine is loved, there is also a love of humanity”
~~ Hippocrates quote
can doctors rate their patients? the ones who don't lose weight, watch what they eat, exercise, manage their blood sugar, take their medicines, quit smoking, have insurance. Doesn't sound right does it.
My sympathies go out to anyone visiting a doctor within the US system. I haven't had much luck with doctors, unless you consider bad luck "having luck." I've searched dozens of doctors and clinics within my area to try to address a variety of medical issues, only to be told a range of "diagnoses," typically with strong meds attached. It has only been in the past 4 months of the past 18 years that a definitive cause was found for 5 major issues (food allergies covered 4 of the 5 presenting problems!) Not one of these doctors looked beyond their noses to really listen to what I said, and how the meds they were giving me were not working. Instead, I was labeled "difficult" and "not following instructions." I'm sure if these doctors were to give me a rating, it would have been very low. However, I was right: they were wrong.
Giving ratings scales for doctors would have been helpful for me in my search for someone who actually listened to what I was reporting. Certainly would have saved me the time wasted.
And to the anonymous blogger saying doctors should rate their patients they will have the right to rate me only if they start paying ME to see THEM.
C. Anne Dover, NH
While helping my mother with her medical care, I have run into some of the most obnoxious, egotistical and arrogant doctors. They seem to concerned with looking like they are in control rather than facilitating not only communiction with patients but with other specialists that might be involved.

It is unfortunate that doctors can create such tension within a patient that they prefer to take their chances rather than being seen. I think doctor's really need to take a course in dealing with patients and remembering that the focus is on the patients health and not their egos.
I am less likely to trust a rating system in which the insurance company is a participant. Just as the Zagats restaurant guide is completely independant from resaurant trade groups I would hope that they eventually come out with a guide independant of WellPoint. I do think a ratings guide is great for doctors but I think it should also include infromation from the licensing boards, ie weather there have been any malpractice suits against that doctor, if the doctors licesnse has ever been suspended or revoked. This information is all available on the internet but if they are going to publish a giude to doctors this information should be included.
I think we should rate our insurance companies and not the doctors. I think the insurance companies play a large factor in why insured Americans are receiving such poor medical care. I think special government auditors should ensure the executives of insurance companies receive the same insurance coverage as the public who pays for the policies.

I think medical doctors work very hard in a system set up by insurance companies to deprive the insured of good necessary medical care. Insurance companies want to save a buck and they don't care about you or your family.

Private insurance reimbursement rates and medicare reimbursement rates are constantly going down. Medical premiums go up and so does compensation for CEO's of insurance companies. Unfortunately, malpractice insurance and the cost of living does not go down.

Insurance companies constantly come out with new 'codes' and 'modifiers' designed to delay payment for servies. On a goo day insurance companies reimburses doctors 90 days after the bill is submitted. It can take up to 6 months to receive payment. Why? Because doctors are considered a vendor. You can't pay your plumber, electrician or hair dresser after 90 days.

Insurance companies reimburse the same as a nurse practitioner thereby depressing the earning power of the doctor. I hope the doctor I'm seeing isn't worrying about his bills because I'd like him to focus on my medical problems.

Insurance companies are harassing to doctors to discharge patients according to their studies on hospital usage. This entire practice seems to miss the obvious point that people are not statistics. Not every medical illness can conform to the average stay in hospitals.

Despite an increasing local population, emergency rooms are closing in my local area.

In the event we are sick, God help us all.
I've had some great doctors over the years, mostly on the specialist side. A few losers, but they are in every field. My biggest issue is with the managed care situation. My primary care physician is nothing but a broker. If he can't fix it with an antibiotic, they just farm you out to a specialist. These operations could be better suited to just nurse practioners. Second, it's hard to find good admin staff at these places. They forget that patients are CUSTOMERS and are the reason they are paid. More doctors should ensure their practices have good service. It's like a mechanic...if you find someone that knows there stuff AND is dependable and reachable, you never want to leave them.
Dear A. Chris,

Please A. Chris, I wish to kindly and gently respond to “anonymous” about doctor’s rating patients.

Yes, it would be odd for doctors to start rating patients. And I can surely understand that we live in a strange world that such a subject would even need to be discussed, to even need a rating for doctors. It is one of the most trusted professions in the world. What would we do without our doctors? We owe them a great debt of gratitude. The gift of life, our life, is in their hands.

There is a line in an old movie (The Divorce of Lady X) “you should never hide anything from your doctor or your lawyer”

We are often raised on that principle, almost a law, our doctor is the one that takes care of us when we need them. We trust them. We have to trust them.

However as to rating, I admit maybe I am wrong about this solution. I don’t know.

But people research important purchases, cars, appliances. Research tourism, best and safest hotels, best restaurants. In fact Why can’t we research the most important facet – the ones caring for our very lives? Even just a vague rating system to give us an idea of what to expect?

At the same time I feel intense PITY for our doctors that are overworked and stressed out. It is a nightmare for them in this system. I truly understand.

But there is a fine line between overworked doctors and an obviously overworked, neglectful and abusive doctor who really NEEDS to take a vacation or something. There has to be some way for a patient to know they are not the only one being neglected or abused, etc. Especially with a person’s life involved.

I do not know the solution but I must admit that I wish there had been a rating system back then as it might have saved me so much pain and heartache. This is a documented fact. If I can even help just one person, it will all be worth it. Please search for the best care and do NOT give up.

We can purchase spare tires and car parts etc., but we cannot purchase spare lives. We have to treasure our life and make sure the ones caring for us truly do care and are listening.

Happily I have a wonderful doctor now. What a gift and what a blessing. I can cope with joy. And to such dear doctors and specialists we owe a debt of gratitude because if we ever lost them to burn out we would suffer so much.

Thank you again A. Chris, this is such an important topic and something I hear about over and over. We live in difficult times now.

In appreciation, G

P.S. A. Chris, I was greatly saddened to hear that one of your CNN health team colleagues passed away, I saw her photo, she was a truly beautiful lady. My heart and prayers go out to her family and friends, you all must be so sad. I’m so very sorry.
Why not rate doctors, and their practices? They are service providers - providing services vital to our health and wellbeing.

On the positive side, when you've found a good doctor and practice, let them know you notice and appreciate their extra efforts. This has made a good relationship (which I'm grateful to have found) even better.

Listen, ask reasonable questions, follow the doctor's recommendations or discuss why you'd like to try another approach. IOW, good doctor + supportive staff + informed patient = success.
How about this for a rating system. I provided my preferences with each rating to give an idea of the type of information that the rating would give to the patient.

Personality: nice, but not bubbly
An exchange of pleasantries is, well, pleasant, but overt optimism or distraction implies a lack of realistic perspective and a possible lack of empathy.

Communication: reserved, but not mute
I don’t want them to think out loud, but I do want them to state their opinion on path forward and why.

Consideration: open-minded, but not a pushover
I want them to consider what I have to say and be a life-long learner, but I don’t want them to give me what I want just to make me happy.

Time: diligent, but not rushed
I don’t want them to spend more time on me than is necessary, but I do want the appointment to be constructive, even if the doctor must spend more than my allotted time. If I wait for an hour while my doctor is giving prior patients this courtesy, I am okay with that.

Discipline: multi-disciplinary, but not superficial
I want them to have a good knowledge of all fields of medicine, but with sufficient depth to be able to consider possibilities and propose a paths forward that are outside of their area of expertise.

Application: wide-ranging, but not unfocused
I want them to have understanding of and access to a broad range of diagnostic criteria and tools, but I don’t want them to just throw a bunch of tests at me.
I myself am a physician and I do care about my patients. I became a doctor because I want to improve patients' lives. However, one thing that in general people do not understand is the long arduous process that it takes to become a physician, and how every year things become harder and harder.
After high school it takes on average 4 years of undergraduate studies, 4 years of medical school, one year of internship (in which I got paid less than minimum wage and worked 140 hours a week), 3to 4 years of residency, and 1 to 2 years of fellowship training or more. During this training the average med student has 250 thousand to 500 thousand dollars worth of loan debt, and are getting paid between $25,000 to 45,000 a year. During this time, they have to pay to interview and travel to obtain residencies, fellowships, and later on permanent jobs- usually without any reimbursement. By the time we finish our training and are ready to start a family we are in our thirties.
Then we start working with still some enthusiasm and continued desire to help our patients. But every year malpractice premiums go up, reimbursement goes down, insurances deny covering the prescriptions or treatments we prescribe despite research showing these are good sound treatments. The government adds more and more restrictions to what we can and cannot do and can and cannot charge.
Most people don't know this, but the number a doctor charges for a service is really not important, because unlike most other businesses, what doctors get payed has more to do with what Medicare and the insurance says they will pay more than what the bill says it cost. And with Medicare cutting costs, insurance companies follow.
This year, our health insurance premium rose by 25%, yet our reimbursement by this same company hasn't gone up, and has actually gone down. What do these companies do with the differences? Probably pay their CEOs and shareholders more. Every year we have to hire people to fight with the insurance companies to pay us, and to try to get treatments approved for patients. Yet every year we get payed less. So our costs go up, and the reimbursement goes down. So unfortunately this means that most doctors have to see more patients a day to cover costs than they did 20 years ago. This means that they have to spend less time with patients to be able to cover the costs of running a practice.
I thinks this is quite sad. Unfortunately, I think it is only going to get worse with the upcoming cuts in Medicare and insurance reimbursement and with the increased cost of living.
All of this leads to doctor burnout. I myself like spending time with patients, working with them. But I am told I have to see a certain number of patients a day to cover overhead. So sometimes I run late so I can give each patient the time they need. But then other patients get mad at me for running late, even if I also spend more time addressing all of their concerns.
So sometimes I wonder why I went into medicine.
If you find a good doctor, not only keep them but also show him or her that you appreciate them. This will go along way.
But will a rating system actually lead to changes that some medical professionals may need?
Went to the doctor for exacerbated chronic low back pain (CLBP). However, the first time the doctor said he didn't have medical records from the orthopedic and neurologist and will wait to prescribe anything. I thought it was BS but I went along with it, they have a chronological list of all my back treatment, tests, and medicines I gave them with the original visit (though different doctor). Two-week follow-up, the doctor again said he would not prescribe anything because of the depression diagnoses. At least this time he was honest about why he would not help my CLBP. But this angered me more, one because I was in physical pain, two because he wasn't honest the first time, three because being depressed does not always mean being actively suicidal. I left the doctors that day hoping I never see this person as long as I live. Though I can empathize with the doctor's dilemma, I as a patient am left without treatment. Now comes the point where I will no longer mention depression as being part of who I am, because not being treated for other ailments doesn't work for me. I would've liked to evaluate this doctor or even talk to their boss/management. Someone to air my grievance. However, at this point I am just looking for a new PCP. I cannot have someone treating me who does not trust me when I have given them no reason not to. It has been recommended to talk with the doctor about my concerns. But this doctor has already formed an opinion of who I am and how I will act so I feel it is best to move on. I would have liked to have an outlet and maybe a rating system would have given that to me. But because I won't go back to this particular PCP, that person will never know what changes they may have to make to be a more productive physician. Maybe a rating system will would also help the doctor.
I agree with the person who said that doctors could be reviewed in published materials just like restaurants. Up here in Canada, I live in a city of about 150 thousand residents and we are short of doctors. Therefore the doctors here seem to get away with too much bad service. I literally call my doctor at least 10 times before the phone will actually reach a human being, and his answering maching does not take messages. even when I do get an answer it takes weeks to get an appointment. One time I showed up late to my appointment and the nurse told me that I would have to rebook the appointment. So I ended up taking my children to the local health unit to get some immunizations rather than rebook the appointment. The whole experience was humiliating. Why is it that a doctor can take hours to serve you while I wait patiently in the waiting room, but if I am late for my appointment they have the nerve to tell me that the doctor can't see me? That is completely disrespectful. They don't care that I was very busy and have four children and was on a very tight schedule. Doctors must be compelled by good will towards their patients or else they should just quit the medical biz.
I have several major medical issues. The physicians I work with range from a fantastic internist/GP to a Ma Kettle podiatrist. I am afraid to change any of them, because I suspect I would only get a lousier MD. Come on, folks, let's get this program going with strength.
I was a pastor for fifty years. The rating system there is perhaps stronger. It is called "The front Door".
If we had this rating system working properly, perhaps we would have fewer real screw-ups in our care and communications.
Maybe you have seen this book, I just found it today online:

http://today.msnbc.msn.com/id/21293866/
I read your posting with interest as I'm a physician that has and is being rated by my patients. I, like many doctors, had been hesitant about this development in healthcare since there didn't seem to be any constructive and fair rating system out there. If ratings are meant to improve patient care, then a doctor needs to be given the chance to review and respond to negative feedback before it's posted. I currently participate in a local healthcare rating system by YourCity.MD--and this rating and feedback system is the site I refer my patients. I'm happy to say my ratings and feedback are mostly positive, but when I do get feedback raising concerns or a problem, this process allows me to confidentially respond to the patient and work out any concerns and thereby improve our relationship. Ratings are fine, but without mechanisms in place to make ratings a means to an end,i.e
improved patient care, it's not really going to improve healthcare.
I don't go to a doctor - I see a nurse practitioner.

I have been fortunate over the years to see several nurse practitioners, and very much prefer them over physicians.

Nurses are trained to treat the whole patient, and are also trained to do patient teaching, so patients and/or family members can care for a patient after they leave the office. Doctors do not receive any equivalent training in patient teaching.

Nurses are also trained to listen to what the patient says, and what they don't say.

When I have been unable to find a nurse practitioner, my second choice has been a doctor certified in family practice. Their training is similar to nurse practitioner training because they, too, are trained to see the whole person, not just a collection of symptoms.

Unfortunately, fewer medical students choose family pracitice as a specialty, because they can't make enough money to pay back their ridiculously expensive tuition bills. The good news is that many medical practices that specialize in family practice hire nurse practitioners.

If you are having trouble finding a doctor, try a nurse practitioner at a medical family practice office.

You will find that physicians are trained to treat diseases; nurses are trained to treat people.

Who would you rather have taking care of you?
I agree 100% with the anonymous physician below. Overhead goes up and reimbursement goes down. The best and brightest are no longer going into medicine so the public can look forward to more and more foreign medical graduates to fill in. I also think it would be interesting as someone suggested in physicians rankning their patients. It's amazing how 5% of your patients take up 95% of your time with never ending complaints, non-compliance, drug seeking, and overall ingratitude. Which is especially irking when you go out of your way to see them in the emergency room and have to rearrange your entire schedule. So what am I saying? Physicians are getting tired of their patients and the reimbursements and medicolegal risks are not worth it. you are going to see the aging physicians (what are approxiately 1/3 >50 years old) retiring in droves over the next few years because they have had it. I'm 33 years old and just recently finished a total of 14 years of school and training. I hate my job with extreme prejudice, but I'm in debt beyond comprehension. Everything I thought about practicing medicine was a lie. The altruistic, naive medical student that I was long ago is dead and gone. What makes me so miserable is the plethora of ungrateful, litiginous patients that have no clue how good they have it here in the US. So when there is a shortage of on call specialists and I am still willing to crawl out of bed at 3 am to see you in the ER I most likely will not be all smiles and bringing flowers. But I'm there to take care of you. And if you don't like it, then find someone else! And good luck doing it!
I'm for open communication - as long as it's fair and balanced. In our practice, we ask all our patients to voluntarily rate our service, empathy, and care at www.DrScore.com This is a better rating system than places likeratemydoctor.com inwhich personal attacks and slander are more common than useful feedback.
As a 2nd year medical student I find all of this horribly depressing. There aren't any educational processes I can think of that are more grueling or costly than becoming a physician in the United States. So after studying away our youth, accumulating $250,000 dollars in debt (I'm at $120,000...YAY), and surviving residency, what do we have to look forward to? Being rated on our communication skills after being forced to see three times the number of patients we should? Super. I can see it now: "Quality of medicine delivered be damned, I was able to get an appointment the same day so we didn't have to miss Timmy's soccer game. Dr. X is great!" -Soccermom21234

Add this indignity to the laundry list of concerns voiced nicely by the physician that responded earlier and you can see perhaps why doctors aren't at their best these days.

I arrived at medical school starry-eyed and ready to make a difference. I've held on to my idealism in the face of a continuous flood of reasons that turns many medical students into the bitter doctors that people complain about. I've watched my girlfriend who is an intern come home from 36 straight hours of on-call work so exhausted and strung out that she can barely muster a hello before collapsing in bed and sleeping the rest of the day and night, only to get up and to do it all over again. The toll this can take on a person is mind-blowing. This is what I have to look forward to in 2 years.

“Wah, wah, wah” is what I say to my classmates when they go down this path (which they don’t like to hear). We knew what we were getting in to…about the endless tests, the money, the relationships sacrificed. Why do we do it? We all have our individual reasons but mainly we do it because we believe medicine is a beautiful art and the noblest of professions.

Or used to be. Now your insurance company controls your care based on profit margins. Like I said, this is depressing.

Please pardon my rant.
why can't we have a list of doctors that have been sucussfuly sued or settled out of court for malpractice.

Every year if we are to take government figures over 100,000 people die due to malpractice .... Not just mistakes or complications but actual malpractice. According to a study I read this number may be as much as 5 to 7 times that.

If good doctors forced disclosure then no one would use bad doctors and then insurance costs would go down and the patients wouldnt be blamed for suing them out of practice after a doctor kills one of their loved ones.... and why should a family settle for $250,000 when a loved one is killed due to malpractice.....

Its just too bad and maybe medical students that get all D's and Drink their way through college and then cross perscribe each other narcotics just need to go out and become garbage men.... but then again I like to have my garbage picked up on time and not spilled all over my front yard so maybe they just need to go to jail.
As a third year medical student, I see plenty of patients who aren't happy with their doctor - the one that I am working with. However since I am often learning or practicing things like taking longer histories to report back to the said doctor, I often get to hear more from the patient about their concerns. Most doctors want to help, and yes many are burdened by the demands of managed care practice or burn out entirely. However consider the steps that put this situation in place. Before you jump the gun on ranting on doctors, check out your insurance company. Or if you are part of the millions of people who are underinsured or uninsured - step up and take action. Lobby to your representative and get them to do what they are supposed to do...represent you and your needs. The system isn't the way it is today soley because of doctors. It is is because of insurance company corporate greed. Think about that the next time you rant about rating your doctor.
Even the good doctors are being controlled by the insurance companies. And, not just for medical treatment. They will not fight the insurance companies that control disability or Workmen's Comp. They just don't want to spend the time. So, a patient that is injured losses their job and their medical benefits.
Without this there is no hope of long-term benefits.
Why would a doctor say" Your back is so bad that no company will hire you" then refuse to sign papers not work a hard heavy lifting job? No guts.
I am a family physician with over 16 years of day to day practice experience and now the Chief Medical Officer of YourCity.MD a physician rating/patient experience portal mentioned in an earlier comment. All of the comments are a testament to the fact that what needs to be rated/assessed is the quality of the doctor/patient relationship and what happens when that relationship is not working well - dissatisfied patients that are not getting the care they need and embittered physicians. Like any relationship, the quality of the relationship depends on mutual trust, respect and bi-directional communication. We at YourCity.MD have developed a system that encourages both patients and physicians to resolve issues when they occur so that both can enjoy the benefits of a better relationship - better patient outcomes and a more satisfying professional career. While this will not solve all of the woes of our current healthcare system, it gets to the heart of what we all need - a good and trusting relationship with our physician.
Rating doctors is good for patients and for doctors. Patients get to see what a good job doctors are doing and doctors get feedback so they can enhance the quality of what they do.

I asked a group of doctors what they thought the average doctor’s patient satisfaction score would be. On a scale of 0-10, they gave answers in the range of 4-6. The actual median score of doctors (with 20 or more ratings) on the www.DrScore.com online patient satisfaction survey website is 9.5 out of 10! Even doctors don’t realize what a great job we are doing, tending to see each others’ failures and rarely each others’ happy patients.

Doctors ought to be encouraging all our patients to rate us on the Internet. For one, the public would get to see a more representative picture of the great job U.S. physicians are doing every day (we certainly aren’t going to see that picture in our newspapers or TV news broadcasts). And two, getting feedback from patients can only help us achieve our goals of giving our patients the best possible medical care.

Steven R. Feldman, M.D., Ph.D.
Founder, www.DrScore.com
barlabarlabarla says:
"I showed up late to my appointment and the nurse told me that I would have to rebook the appointment. ...The whole experience was humiliating. Why is it that a doctor can take hours to serve you while I wait patiently in the waiting room, but if I am late for my appointment they have the nerve to tell me that the doctor can't see me? That is completely disrespectful."

I think it is entirely unreasonable and disrespectful to walk in late for an appt (and she didn't say how late, so it must have been more than 3 minutes) and demand to be seen. Does that poster realize what impact this has on all the other patients waiting???
True, sometimes doctors run behind, and often, it is because of patients like the above, who wasn't even having an emergency, and who had demands.

Consider how many patients demand more pain killers to hoard, demand more antibiotics that are unnecessary, demand unnecessary surgery because of pathological attention-seeking, demand to be seen for a hangnail, demand their child's flu to be cured magically. The list goes on.

A physician rating system is in principle a good idea, but the above poster is a poster child for the fact that A LOT of patients are unreasonable and don't have the sense or maturity to write a fair and meaningful evaluation.
Just be reasonable, who appears to be a physician, has reason to be concerned about ratings systems that primarily apeal to dissatisfied patients. To be fair to doctors and to help patients get the care they want, a rating/feedback system should be one where the doctor recommends the site to their patients because they want to improve care (and most doctors do)and gives doctors the opportunity to respond to the patients issues or concerns before it is plastered all over the internet. Our extensive experience at YourCity.MD is that over 90 % of patients have very postive feedback to their doctor and that when doctors recieve negative feedback in a confidential and private form, they will respond to the feedback and often remedy the situation to the patients satisfaction. We agree that patient feedback and fair ratings are important to both doctors and patients alike but it has to be a fair and reasonable system, not a national whipping post for doctors. That does not improve care or outcomes.
I have to agree that the insurance co. cause a lot of problems. I recently swicthed insurance and my current doctor did not accept the new insurance so I had to find a new doctor. Which I did and brought in all of the medications that I was on to have her refill them. She looked at the bottles and wrote the scrips and told me I would have to see a specialists for my medications next time and I asked her for a referrel she gave me the same doctor I went to before. I then explained the my insurance did not cover his treatment. she told me to find my own specialist because she did not have time to look and she also got two of my medications backwards so when I went to refill the one I ran out of early the insurance co said they would not refill it unless the doctor called them to tell them she made a mistake which she refused to do. I would love to rate the way she treated me
To all the people who have requested that malpractice lawsuits and settlements be included in doctor ratings...

My father, who has since passed, was a small business owner whose company wrote and installed computer software for manufacturers.

He was sued at least once a year when I was growing up. Much like doctors, subcontractors frequently are named in lawsuits in which the plaintiff adds anyone who was present (in the form of product; for doctors that means physical presence at some point in care) to the lawsuit. In the course of these 20-odd lawsuits, at no time was his company at fault. But he spent time and money telling the courts and proving that to the plaintiff, and settled some out of court simply because there was no other way to get rid of the endless appeals.

In our legal malpractice system there is no distinction between lawsuits that arise from a) genuine malpractice, b) genuine medical error (regrettable but not the fault of the doctor) and c) lawsuits that are filed with no basis but are allowed to stick based on paid experts, etc. Yet all three of these situations would show on a doctor's record, because such ratings wouldn't distinguish how many of them were paid to go away for legitimate or frivolous reasons. Sure, a judge or jury might have thrown out that case, but the legal fees to defend it would likely have been far worse. Settling is easier, and in many cases it's the insurance company that chooses to settle -- if the doctor wants to keep his coverage, he has no choice but to accept their decision.

If my dad had been rated like a doctor, he wouldn't score very high. He wasn't very personable and he was sued frequently. But he was very good at his job and the lawsuits he settled were not because he was incompetent.

I believe that ratings like YourCity.MD allow constructive criticism, with the small amount of moderation any internet-based rating system needs. I'd be interested in having disciplinary actions taken against the physician included. But until you can individually review malpractice cases and settlements for actual malpractice, perhaps they're best left out.
I think the communication is one of the more important
part of the patiente and Health professional relationship.
After two years in Portland and visiting several Doctors, I found a Nurse Practitioner that is taking care of my conditions very professional, Well I just have to say she top all the previous MDs.
Thank you Mrs.Leslie
I agree that communication between a physician or any clinician is key to a good doctor patient relationship. Numerous studies show that patients more often file malpractice lawsuits because they are angry with the physician than because they were harmed by a medical error. That is why YourCity.MD is designed to confidentially bring to the physician's attention when a patient is angry about their care. The physician then has the opportunity to contact the patient and resolve the issue. We have many examples of physician intervention restoring a good relationship with the patient to the benefit of both the patient and physician. Those patients often become proponents of the physician because they realize the physician cares about them and the care they have received. Those patients don't file frivolous lawsuits. We at YourCity.MD strongly believe that improving the doctor/patient relationship is key to improving healthcare.

Michael Barber, MD

Chief Medical Officer

YourCity.MD
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