Monday, June 1, 2015

What Do Dr. McDreamy, The One-Eyed Guy Behind the Curtain, and George Clooney Have in Common?

What is a doctor rating and why are doctor ratings sites important for doctors and for patients?  Before Al Gore and the invention of the internet

(I know…I know…the two have nothing to do with each other except that one opened his mouth while the other was spawned), there were no doctor ratings. 
Word of mouth and personal recommendations reigned king as the sole way for patients to get information about which doctors were good and which ones were better intended as butchers, bakers, or candlestick makers. 

In the old days, if a patient needed a good primary care physician or specialist, they would ask friends at work, church, school, etc. for a recommendation.  God forbid that they were involved in an urgent or emergent situation, then they were forced to go with the one-eyed guy behind the curtain that the ER doctor suggested.  Oftentimes still, patients rely on their personal physician to pick a specialist for them without any research, background, or query about their attributes.  Need I remind you that a doctor's attributes may be the least important part of the puzzle.  Reference:  George Clooney on ER and Dr. McDreamy on Gray's Anatomy might have been the most handsome men on TV but probably couldn't spell "medicine".  Not to mention how smart Dr. House was on House, but seriously that show was produced just to agitate and confuse doctors.  

With the advent of the internet, healthcare ratings sites surfaced and patients began rating doctors based on satisfaction scores.  Now 60% of patients will search for a doctor online before they see him/her.  Ninety percent trust these recommendations.  What most patients don’t know about these ratings is that these sites in general contain only a few patient ratings that are usually based on DISSATISFACTION not satisfaction (the good recs are usually from relatives and/or employees of those doctors).  There is no way for sites like this to be unbiased, they are breeding grounds for tricks and maneuvers to improve online reputations.  Some sites seem to have grown more popular than others, yet there is still one major missing link to the whole doctor rating scenario:  a peer rating system.  

The clear question about this space is:  who knows which doctors are good or bad better than other doctors?  The answer is easy.  Doctors work side-by-side with each other on a daily/weekly/monthly/yearly basis.  Doctors rating other doctors seems to be the only way to get the best information about referral patterns and recommendations.  Bias is inevitable due to ego and hard feelings, but the eventual truth should come based on an aggregate score.  The goal of a peer rating site like is to eliminate the need to call your favorite doctor-friend in the middle of the night to figure out who the best doctor is in a certain field or at a certain procedure or surgery. 

Why is all of this important?  The answer comes from two different perspectives- the doctors and the patients.  

First, doctors generally feel that they stay in touch with the referral patterns of their peers but acknowledge that they can get into repetitive ruts where they will send patients to a doctor based on a friendship or prior knowledge of that person’s reputation.  

Second, with all of the medical specialties and subspecialties out there now, it is impossible for a doctor to know which person is best at which microcosm of medicine.  For peat's sake, we have hand doctors who focus on nothing else.  If a problem arises in the elbow, they have to call for backup.   

Third, with a healthy peer rating system, doctors would be able to not only identify and promote the doctors who are clearly in the upper echelon of the food chain but also tease out which doctors would do better as veterinarians.  Referral patterns are likely to change slightly with this new process as some doctors are going to have "ah-ha" moments while others will continue on without any changes.  

Fourth, patient satisfaction scores to date have avoided a mainstream following amongst doctors.  However, with the initiation of pay-for-performance or quality-based remuneration by insurance companies (doctor ratings might determine how a doctor gets paid in the future), doctors are starting to pay attention to this medium a little more.  We can leave all of the money-hungry doctor jokes alone for now.  

Anger and angst have long been the two most common feelings after doctors look at their online patient satisfaction based profile.  A peer based system will give the doctors something to embrace- we always want to be in control, it is in our nature.  A peer ratings system gives the doctors control of their destiny in a sense.  

Finally, this concept of physician peer ratings is not meant to completely annihilate patient satisfaction scores.  In fact, patient satisfaction scores are immensely helpful when taken in large quantities.  Critical mass is necessary to obtain a statistically significant patient driven doctor rating.  No matter how this medium progresses, though, the patient is destined to be in a better informed situation in the future.  Peer ratings are likely to drive more patients to rate than before.  When patients start searching for and talking to their doctors about peer ratings, we are likely to see a dramatic uptick in volume of patient and peer ratings of doctors.  

When you combine peer and patient ratings, the whole healthcare community wins.  Sign up at and start rating today!

David Jones MD is the owner of, a physician peer rating website, and a private practice cardiologist.  

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