A lot of good information - and misinformation - about doctors is available on the Internet. As you research doctors, you may come across physicians ratings or rankings websites.
Just like plumbers, hairdressers or painters, physicians' services may be rated, ranked, advertised, or otherwise promoted online. But just like ratings for other service businesses, the information must be interpreted to be sure it accurately reflects the person and the service provided.
Not all the available ratings or rankings sites provide correct information. It's up to us patients to figure out which ones are most useful as we judge a doctor's competence to diagnose and treat us.
What Kinds of Ratings Sites Exist?
There are four business models for doctor rating or ranking sites:
- Private or nonprofit sites that provide information at no cost to patients. These range from the various professional boards that certify doctors to those that are advertising-based or charge fees to the doctors, other professionals or facilities to be listed.
- Private ownership sites that charge a fee to patients to access this information.
- Insurance company sites. Several health insurance organizations have built, or are in the process of building, doctor reference sites for their insurance customers to use. Some are hiring companies that rate other things to build these databases for them. For example, Zagat built a ratings site for Wellpoint Health Insurance.
- Government sites provide information about the doctors licensed in their states.
What Information Do You Want to Know About a Doctor?
At the heart of the matter, you want to know whether a doctor will diagnose you and treat you effectively, in a place you can access, at a price you can afford or are willing to pay, which may include not just the cost in terms of money, but also the cost in terms of time, and the effect on your quality of life.
That information breaks down into four different categories:
- You may need basic contact information which may best be found at the doctor's own website, or through a hospital where she has privileges.
- You'll want to check credentials including education, experience and certifications, which is found at directory-type sites, although it may also be found at some of the ratings sites.
- If possible to find, cost or insurance acceptance information will be helpful. If you have insurance, the best place to find this information is at your health insurance company's website. If you don't have insurance, there are alternatives.
- You want to know whether she is a "good" doctor. This is the foundation for the sites that rate or rank physicians.
How Are the Ratings or Rankings Developed?
Typically there are three approaches. One system uses a formula, called an algorithm, built by the site's owners which gives different weight to different aspects of the doctor's education and experience. For example, one site might give extra points to a doctor who went to Harvard Medical School, and less weight to a doctor who went to a medical university in another country. Another site might give extra points for a doctor who achieved a fellowship in her specialty area. Another site might subtract points for a doctor who has settled out of court on a malpractice case.
A second approach involves patient input. Patients are invited to rate their doctors on many aspects of a visit; everything from how clean the office was, to how promptly the appointment took place, to how clear the doctor was while explaining a treatment option.
A third approach combines the first two.
The way these formulas are developed is perhaps the biggest problem with these sites, in particular the ones that invite patient input. How one patient or formula defines "good" is not necessarily the same way another defines a good doctor.
How are aspects of a doctor's capabilities or history weighted? Who decides? None of the ratings / rankings websites will divulge their formulas, so we don't know the answers.
As for the ratings provided by patients, nothing but subjectivity is involved. How long is "too long" to wait to see a doctor? Who defines how clean something must be to be "very clean?" Further, too many patients confuse good with nice. It's human nature to prefer a doctor who speaks nicely to us and spends time answering questions, but that doesn't necessarily translate to being a better practitioner.
What Are the Potential Problems with Physician Rating or Ranking Sites?
Many potential problems could affect your care if you don't understand the potential pitfalls.
If the database isn't kept updated, then you may not know about the most recent track record. For example, a doctor may move from one state to another, but the ratings site may not catch up to the move for a year or more. A malpractice suit may be settled, but the results may not show up online for 18 months or more.
There is a possibility that the doctor herself, or a staff member or family member could be the person doing the rating on the sites that invite patient input.
There may be several doctors with the same name (for example, more than a dozen oncologists are named "Robert Smith") and their records may get mixed up, or a patient may rate or rank the wrong one.
Patients can be bribed to provide positive rankings/ratings. One plastic surgeon offers discounts on future services to patients who provide positive feedback about the services he has already performed.
Finally, when a patient makes an accusation, there is little or no opportunity for the doctor to tell his side of the story. Some experts will tell you that up to 60% of all malpractice cases never result in a penalty for the doctor or professionals named in the suit. Granted, there may be several reasons for that, including settling out of court. But a suit or an accusation is not the same as a guilty verdict.
You may even consider making your own contribution to a doctor ratings site one day. Here's how to decide if that's a good idea and if so, how to do it fairly and accurately.