- The Washington Times - Wednesday, September 16, 2009

The search for a doctor begins, for many people, much like a search for a car or a new restaurant — online.

Potential patients now have around 40 Web sites to choose from, with reviews of hundreds of thousands of doctors nationwide. Some sites are sponsored by insurance companies and feature doctors in their plan. Others are strictly consumer-driven. Even Zagat, publishers of the well-known restaurant guide, and Angie’s List, best-known for helping consumers find plumbers and painters, are now in the doctor-rating business.

While online resources can be a good starting point to locate some physician specifics, such as proximity to your home and whether the doctor is in your insurance plan, it is the more subjective information that can be confusing.

“When you have only one or two reviews of a doctor, it is usually someone who is incredibly blissful or incredibly unhappy,” says Dr. John Santa, an internist and director of Consumer Reports’ Health Ratings Center. “That’s not very useful.”

Even if there are more than a handful of consumer postings, the results are often contradictory. Take, for instance, some of 27 reviews of Dr. Margaret A. Byrne, a District OB/Gyn, on Ratemds.com:

“Love Dr. Byrne. She’s great. Really knowledgeable and helpful.”

“Have a questions about test results? She won’t return your call.”

“She is abrasive and has the gentle touch of an elephant.”

“She’s the best.”

Thanks to the cloak of anonymity protecting many of the posters to these rating sites, it is often very hard to evaluate the motives or credentials behind the customer reviews.

“Some [sites] allow postings to be published anonymously, and there is no guarantee that the opinions about a physician even come from that physician’s patient,” Dr. Nancy H. Neilsen, immediate past president of the American Medical Association, said in a statement. “People may express dissatisfaction on these forums because they wanted a medication that wasn’t medically necessary, or because they didn’t receive a prescription or service that was delayed or denied by their insurance company.

“Online opinions of physicians should be taken with a grain of salt, and should certainly not be a patient’s sole source of information when looking for a new physician,” said Dr. Neilsen. “Patients can ask family and friends about their physicians; getting information from someone you know is more reliable than from someone you don’t. Choosing a physician is more complicated than choosing a good restaurant, and patients owe it to themselves to use the best available resources when making this important decision.”

Dr. Santa says there are even more fundamental issues with consumer sites. With more than 800,000 board-certified doctors in this country, forming an accurate database is “impossible,” he says.

“Many sites are not current and not accurate,” he says. “Let’s say someone is posting about Dr. Robert Smith in New York City. How can you be sure the patient got the right Dr. Smith?”

The sites themselves warn consumers to use consumer ratings as just one tool in picking a doctor. John Swapceinski, co-founder of Ratemds.com, admits the anonymous posters to his site are either “extremely happy or extremely unhappy.”

Scott Shapiro, spokesman for Healthgrades.com, another physician and hospital ratings site, has a more uniform approach to consumer feedback. Posters to Healthgrades.com fill out a questionnaire rather than type off-the-cuff remarks. Healthgrades.com reports look more like report cards than anything-goes Internet chat rooms.

However, like anything online, once remarks are there, they are hard to delete. In Internet law, Web sites are not liable for information posted, and it is extremely hard for doctors to prove libel in these cases.

Mr. Swapceinski says his site tries to self-police what is posted.

“We have people on staff reading every single review within 24 hours of it being posted,” he says. “We will delete a post if it accuses a doctor of illegal activity and there is no evidence to back it up. … If a doctor does not agree with a post, he can red-flag it, and it will be reviewed by a staff member again. Doctors can also respond online to what has been written. Anyone can.”

However, Mr. Swapceinski says that many doctors learn from what is posted.

“The vast majority of comments are about customer-service issues,” he says. “A lot of times, doctors don’t know what is going on in waiting rooms. This gives them a window.”

One company, Medical Justice Services Inc., which offers services to help doctors avoid malpractice lawsuits, recently began offering Mutual Privacy Agreements. Doctors can ask patients to agree to respect their privacy the same way doctors agree to respect a patient’s privacy. By having a signed contract, doctors can have some legal basis to ask Web sites to take offending or inaccurate posts down.

“In few other occupations is an individual’s reputation more important,” says Dr. Jeffery Segal, a physician and founder of Medical Justice Services. “A physician’s most valuable asset resulting from the years of training and experience is his or her reputation. It’s something you can literally spend decades building, and it can be ruined in a few seconds with the click of a mouse.”

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