What’s up with docs?
How much can you find out about a doctor before you commit to a lost day of work, an hour of paperwork and a co-payment for your first visit? What can you find out in advance about a surgeon to whom you’ve been referred for a critical procedure? What should influence your decision making? Are you a sentimentalist who still believes there’s a correlation (positive or negative) between bedside manner and medical competence, or a stats geek who chooses based on numbers alone?
These are some of the serious questions behind the news-of-the-fun story that Zagat, the restaurant-rating giant, has teamed up with WellPoint, the massive health insurer, to provide patient ratings of doctors.
The online service, which will be available only to WellPoint clients, is hardly the first effort to make doctor information more widely available. The popular (with patients) and controversial (with doctors) RateMDs.com allows users to enter comments about, and assign smiley or frowny faces to, their doctors. For $40 or so, Healthgrades.com will provide you with a dossier that is valuable mainly for letting you know if the doctor has settled any malpractice claims. You can find comments in the health sections of general-interest ratings sites, and there’s always the random blog post that will contain some inside dirt on a local doc -- much of it focused on how good the parking is around the medical office, and virtually all of it coming from people who, though they can judge their own experiences in a doctor’s office, are not qualified to rate a physician in any formal sense.
Each of these sources is useful, but taken together, available doctor information is, well, pretty weak medicine. More than a decade into popular Web history, well into the trend toward illness blogs and cancer wikis that observers have not surprisingly dubbed “Health 2.0,” it’s still easier to get reliable information about lunch, iPods or sex offenders than about doctors. If you’re looking for a one-stop site that mixes qualitative and quantitative data, including information about outcomes, legal actions, education, specialties, feedback from other patients, costs, relevant comparisons and other tips that rise above the scuttlebutt level, you may find parts of it, but you won’t find it all in one place.
Much of this problem is structural. You may visit five restaurants in a week, but it’s unlikely you have more than one or two doctors, which makes user-generated feedback a tougher proposition. There’s an even greater database challenge: Unlike the real estate industry, which maintained an industry bible in the form of its old Multiple Listing Service, the medical profession does not maintain any single database of relevant doctor information.
Still, the medical and legal establishments have not been hurrying to solve, or even acknowledge, this problem. Medicare has resisted making its claims database -- the largest collection of such information in the country -- available to raters. When RateMDs began to take off, the Canadian Medical Protective Assn. tried to get the site to turn over IP addresses for its anonymous commenters. On Monday, New York state Atty. Gen. Andrew Cuomo wrung some small concessions and financial agreements from Cigna Corp. over the insurer’s physician rankings, though it’s unclear that there’s anything wrong with those cost-based rankings -- after all, you pay more for an overcharging doctor just as your insurance company does.
Few things are more frustrating than trying to get information about medical costs and outcomes before committing to a procedure. But the prognosis is improving. In August, a U.S. District Court in Washington, D.C., ordered Medicare to turn over records to a local consumer ratings group. Patients stuck with high medical bills can make comparisons at Mymedicalcontrol.com and try to knock down the price. The startup Vimo.com is using public records to figure out what prices insurers actually negotiate with hospitals, and social networking sites such as Revolution Health are gradually making information-sharing easier among patients.
It’s a slow process, but the Zagat/Wellpoint announcement is another small step toward making your choice of doctors as informed as your choice of burgers.
