I’d like to point out an error I made during a more optimistic time in my online career. Last year on my blog I suggested that physician ratings were “here to stay” so physicians should “embrace the inevitable.” What I hadn’t thought through at the time was the fact that virtually no one would use the ratings tools. I had made a fairly narcissistic assumption: that everyone cared so much about their healthcare experience that they were dying to describe it online.
The truth is that any online tool, portal, social network, or health 2.0 application must deliver a compelling “value proposition” to the user, especially if participation requires any degree of effort. It is human nature to take part in activities that reward us for our time. For example, we may slave over a hot stove because we stand to gain a delicious, satisfying meal in the end; we continue to work at jobs that we dislike because the paycheck makes it worthwhile. But why would a patient fill out a lengthy survey about his or her doctor when there’s no obvious value to them in doing so?
A recent article in Slate (h/t to the ACP Internist) makes a compelling case for why physician-rating sites have such low participation rates as to be fairly useless. The return on investment (time spent filling out a long questionnaire) is extremely low, and is worthwhile to only the most irritated patients. And of course, there is no policing of contributions – physicians can rate themselves into the highest quality rankings by logging in as fictional patients.
So does this mean that there are no worthwhile physician rating tools online? The Slate author would have you believe that there are none. However, I would suggest that Castle Connolly’s America’s Top Doctors list is a reliable, if somewhat limited source. Why? Because teams of staff (who are paid by Castle Connolly) do the heavy-lifting, requiring no effort from patients or online raters. Castle Connolly reviewers first request nominations for physician excellence from within a given specialty and region. Peers nominate others for the honor and then the Castle Connolly staff seek corroborative data from surveys sent to physician peers, hospital administrators, and support staff to ensure that nominated physicians are indeed highly esteemed by many of those with whom they work. In the end, about 10% of physicians are fully vetted and included in the list – and I’d say that the selection process is quite sensitive but not specific. In other words, a physician listed in America’s Top Doctors is likely to be excellent, but many excellent physicians are not captured by the methods.
I spoke to John Connolly in a recent interview about how to find a good physician and you may listen to the podcast here. Locating a good doctor is not too difficult – but finding one that will take your insurance (or still has some slots available for new patients) is another story.