With the advent of eBay and Amazon, the consumers of the world are crazy about rating everything, from product quality to service delivery. We rate movies on Netflix, books on Amazon, and products at Walmart.
You may or may not have noticed, but these days many people are also rating their doctors on the quality of care they receive. Yup, doctors, hospitals, and nursing homes all have report cards now. For instance, the Golden, CO based company, Healthgrades, gives out grades based on its survey of Medicare and other records. If you are a consumer and you want to access the report on a specific physician or hospital, you must pay a small fee. For instance, I checked on my family physician and I could buy the report for $12.95.
On another site, called RateMDs, you can actually rate your doctor publicly. I again checked on my family physician and found her among a huge list. I clicked on a button to add my rating, and was about the quality of the staff's helpfulness, the doctor's punctuality, the doctor's helpfulness and approachability, and finally, the doctor's knowledge.
I was asked to rate each of these categories from 1 through 5. I was also asked about my method of payment, the amount I paid, and whether I had any further comments. The site also included a detailed warning:
"Libelous or very short comments will be deleted. Further, this is not the right forum for reporting illegal activity, unless you include a link to a site with supporting evidence. And remember, you are legally responsible for what you write here. Submitted data become the property of RateMDs.com. IP addresses are logged."
Doctors Rebel Against Report Cards
After this little experience, which was interesting, I did a little research on physician report cards and discovered two things: doctors don't like being graded, and they might be right.
On the first point, doctors don't like report cards for a number of reasons. Ratings, like those offered by Healthgrades, can be tricky, depending on whether the ratings adjust for the quality of data. For instance, one study compared the outcomes of angioplasty patients in New York and Michigan. The New York physicians that performed the angioplasties came up smelling like roses, since their patients had far fewer complications. However, once researchers reviewed the patient data, they realized that the Michigan patients were far sicker to begin with. When they adjusted the ratings based on this further refinement, the physicians in the two states came out relatively equal.
In reaction this kind of grading, which often is subjective or doesn't take into account all the necessary factors, some physicians are rebelling against scorecards. A percentage of physicians are now asking their patients to sign legal forms promising not to reveal "any unfavorable information about the doctor's care, manner or office staff."
There are questions about whether these waivers are legal and whether they will stand up in court. In the meantime, however, don't be surprised if your physician hands you one of these waivers, along with the other reams of normal paperwork.
Will You Sign a Waiver?
Will you sign one? It's up to you. It really depends on the relationship you have with your physician. Patient-advocacy groups claim that patients really need to have a voice, and that websites like RateMDs give patients that voice. On the other hand, this kind of "grading" can cause some physicians to deny certain kinds of patients care, afraid that complex cases will drag down their statistics.
It's a tricky situation, and this is just a "heads up" that you may soon be seeing these new waivers. Start thinking now about whether you will sign.
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