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I was most interested in a recent article on doctor rating sites and
the role that they could play in influencing standards of medical care
(1). Whilst I can fully see the merits of the
‘servicesectorcomparison.com’ culture that we all now live in, I concur
with the view held by McCartney that the application of these sites to
medicine is ‘untested and potentially dangerous.’ I, like the author, am
very concerned that some specialties will fare worse than others within
these rating systems by virtue of their inherent nature. I believe that
these online ratings will act as a surrogate marker for the specialty and
not accurately reflect the professionalism of an individual doctor.
In psychiatry for example, much of the work involves difficult-to-
engage and marginalised patient groups. As I can testify from my own
experiences, I have probably received more thank-you cards and gifts
during my pre-registration house officer year than in my entire
psychiatric career to date. This either makes me a lousy psychiatrist (or
an exceptional house doctor) or that there may be a fundamental difference
in the way that patients within the different specialties register their
approval of doctors. For example, are detained patients with severe
personality disorders more likely than not to report a wholly positive
experience at the hands of their treating team? I doubt it. Likewise, are
patients with severe dementias likely to be able to report a strongly
negative experience of care? Again, I am sceptical.
Having aroused my curiosity, I conducted a brief straw poll on the
iwantgreatcare.com site. The average scores on doctors from 3 specialties
in the London area were calculated. Both emergency medicine and cardiology
returned an emphatic 100% approval rating whereas psychiatry lagged at
94%. Again, this could be related to differing clinician performances,or
as I allude to above, the specialty itself.
The fact remains that looking for a doctor is never and will never be
as simple as switching to a different electricity or broadband provider.
The folly of this reductionist approach to healthcare will be to the
detriment of patients and doctors alike.
References
1. McCartney, M. Will doctor rating sites improve standards of care? BMJ
2009; 338: b1033
My doctor is better than your doctor. Can being rated average ever be great?
I was most interested in a recent article on doctor rating sites and
the role that they could play in influencing standards of medical care
(1). Whilst I can fully see the merits of the
‘servicesectorcomparison.com’ culture that we all now live in, I concur
with the view held by McCartney that the application of these sites to
medicine is ‘untested and potentially dangerous.’ I, like the author, am
very concerned that some specialties will fare worse than others within
these rating systems by virtue of their inherent nature. I believe that
these online ratings will act as a surrogate marker for the specialty and
not accurately reflect the professionalism of an individual doctor.
In psychiatry for example, much of the work involves difficult-to-
engage and marginalised patient groups. As I can testify from my own
experiences, I have probably received more thank-you cards and gifts
during my pre-registration house officer year than in my entire
psychiatric career to date. This either makes me a lousy psychiatrist (or
an exceptional house doctor) or that there may be a fundamental difference
in the way that patients within the different specialties register their
approval of doctors. For example, are detained patients with severe
personality disorders more likely than not to report a wholly positive
experience at the hands of their treating team? I doubt it. Likewise, are
patients with severe dementias likely to be able to report a strongly
negative experience of care? Again, I am sceptical.
Having aroused my curiosity, I conducted a brief straw poll on the
iwantgreatcare.com site. The average scores on doctors from 3 specialties
in the London area were calculated. Both emergency medicine and cardiology
returned an emphatic 100% approval rating whereas psychiatry lagged at
94%. Again, this could be related to differing clinician performances,or
as I allude to above, the specialty itself.
The fact remains that looking for a doctor is never and will never be
as simple as switching to a different electricity or broadband provider.
The folly of this reductionist approach to healthcare will be to the
detriment of patients and doctors alike.
References
1. McCartney, M. Will doctor rating sites improve standards of care? BMJ
2009; 338: b1033
Competing interests:
None declared
Competing interests: No competing interests