Sunday, November 15, 2015

Doctor Networking...The Case for Peer Ratings



Facebook, Twitter, LinkedIn and more recently other sites like Instagram and Pinterest have emerged as complex social networks that “serve” the public in a variety of ways.  I put serve in quotations because it is thought that social media may be the single biggest detractor from corporate productivity (if you don’t count the glut of federal holidays) with fantasy sports leagues like Fantasy Football in a close second.

Facebook and Twitter have historically been more social and less professional.  LinkedIn specifically attempts to allows its users to develop a professional network in which you can interact with contemporaries and competitors alike.  Millennials seem to enjoy the “climbing-the-ladder” approach found on this site as they jockey for a better job while they sign the contract for their current one.  Medicine is different- isolated or at least insulated as a whole from the outside world similar to a caterpillar in its lazy cocoon.  Until recently, medical networking was a good ole boys network rather than a consolidated, organized effort.  Part of the reason for this has to do with the relative stability of jobs and lack of perceived backscratching that goes on in medicine compared to the real world.  Unfortunately, this lack of networking by doctors has meant that medical societies struggle to gain traction in politics and other arenas due to an unharmonized group of semi-precocious individuals- none of whom want to be told what organization in which to be involved.  This makes doctors appear to be a rag-tag group of highly intelligent, social phobic professionals who probably achieve un-“connected” time easier although not quite as often.   

Don't get me wrong…there are doctors on Facebook and Twitter who post professional content, but, for the most part, pictures of kids’ birthday parties and tweets from the latest hip celebrity seem to gain far more attention on these two particular sites.  LinkedIn has made an inroads to doctors and has gained a following in which doctors share their experiences, accomplishments, and also can grapple for the next best job in their field.  Admittedly though, I find very little useful about LinkedIn other than to keep up with friends and colleagues who are not on other social media sites.  

Doximity is a newer, doctor-only site that claims to have 2/3 of US doctors signed up and offers physicians a chance to integrate several needs into one site.  It asks new users to identify colleagues and friends but provides no easy way to interact with them.  It also allows doctors to sign up for a news feed based on professional preferences, but is clearly inferior to reading your favorite journals and medical websites.  Doximity also provides other free services like HIPPA compliant faxing and mail which are interesting but rarely used.  In the end, it just does not provide enough interactive media to take off.  

Since I have now detailed why US physicians are social media averse yet clearly need to be united by this area (think about the fight against Medicare cuts and the challenges of Meaningful Use), I want to point out how a doctor networking idea might work.  A good majority of US doctors are in private practice.  Private practice can be considered to be one of the best examples of supply and demand in America in that good doctors generally succeed while bad ones flounder.  The only real exceptions involve communities in which doctors (usually sub specialists) are in such short demand that patients will flock to a bad doctor because they have no other option.  Private practice doctors require word-of-mouth referrals from friends and family members as well as medical professional referrals from nurses, techs, as well as other doctors. Primary care physicians like internists, pediatricians, and family physicians rely less on other doctors for referrals and more on the friends and family discount. 

Although word-of-mouth referrals are a great way to build a practice, there seems to be something substantive and objective missing when it comes to the current process of doctor networking.  More and more, patients are turning to the internet for answers to the question:  “which doctor should I see?”  The problem is that search engines are the first stop and about 60% of first-page results on Google are from sites that offer patient satisfaction ratings.  You might ask why this is not objective, and the truth is that most of these sites have a scant few ratings mainly from dissatisfied patients.  To boot, there are now companies whose sole purpose is to charge physicians to make their ratings look better on these sites.   Thus, a physician’s online reputation is not only clouded by dissatisfied patients but also by greedy companies trying to help gain the system.  

Patient satisfaction scores from the internet and in paper form (after hospital discharge) are also poised to have a major impact on future physician reimbursement.  Press-Ganey already has a stronghold on Medicare, and by report, their executives are very aggressive with the company’s marketing strategy and it’s growth expectations.  Hospital-discharge patient satisfaction scores are not often a bell-weather for what is good or bad in physician care as the patients who are most unhappy about their care tend to be the ones most likely to take the time to fill out a satisfaction card and send it back.  An even more reprehensible part of this process has to do with how Press-Ganey and hospitals allocate these scores.  A consulting physician can give great care to a patient but then be placed on the hook for a bad outcome caused by either an unrelated medical illness or another doctor’s service.  For the record, none of this bodes well for physicians and their professional networks.  

Most physicians think that they cannot change the current process and feel helpless by their online ratings and post-hospital discharge scores.  One way for physicians to succeed in the Press-Ganey war is to educate patients at discharge about the need for them to return their satisfaction cards after discharge as part of the routine discharge instructions.  Press-Ganey scores will eventually be public knowledge.  Until physicians take an active role in this arena, our professional reputations will hang in the balance.  

For obvious reasons, doctors MUST take control of their online and professional reputations and form a professional doctor network.  In so doing, a doctor can build a network by rating his/her favored coworkers on DoctorRated.com (the only site on the web that allows physician peer ratings) and ask them to rate him/her back.  In addition, a simple DoctorRated card or poster in the exam room can ask patients to rate the doctor and thus provide a fighting chance against the chronically dissatisfied patients.  DoctorRated has a packet with printable posters and signs that is available by emailing DoctorRated@gmail.com.  The good old days of practicing medicine in a vacuum without outside interference are gone, go out and develop your DOCTOR NETWORK today.  



David Jones MD is the founder/owner/chief blogger at DoctorRated.com, the only physician peer ratings site on the web. 

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