December 1st, 2008 by Dr. Val Jones in Opinion
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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.
December 1st, 2008 by Dr. Val Jones in Announcements, Medblogger Shout Outs
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This is one awareness day where your coffee habit can make a difference. Starbucks is donating 5¢ to the Global Fund for every Starbucks beverage sold on December 1, 2008 at participating US and Canada locations.
h/t Emergiblog
And Dr. Anonymous has a nice post about World AIDS Day, citing this letter from a survivor:
(This is an excerpt from a letter to the editor from the Cleveland Plain Dealer from November 30, 2008):
I am a 20-year survivor living with AIDS, and another World AIDS Day (Monday) is fast approaching. Food trays once left at hospital room doors of those dying from AIDS are now being served. The preventative measure of “gown ing-up” has come and gone. However, the stigma of AIDS has stayed unchanged. Sadly, there are conflicting AIDS transmission fears and infection rates spiraling out of control.
I am blessed in that I am still here, with thinning hair, bifocals and my AARP card in hand. I am living proof of the incredible medical strides made in managing HIV/AIDS. I am blessed in living to see nieces and nephews come into my world and bring forth great-nieces and great-nephews. I am blessed in that I continue to continue. I still grieve for the many friends I’ve lost to AIDS.
This year, another 56,000-plus Americans will become needlessly infected with HIV/AIDS. We know how to prevent HIV infection. We need to wage a War on AIDS in America. We know how to win it.
Robert W. Toth — Cleveland, OH
November 30th, 2008 by Dr. Val Jones in Humor, Medblogger Shout Outs
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Men in Dog House
httpv://www.youtube.com/watch?v=SecVCh9dg4I
h/t to Dr. Wes
Bonus: try to hear the “messages” being voiced in the background.
November 30th, 2008 by Dr. Val Jones in True Stories
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The successful “Engage with Grace” campaign resulted in ~95 bloggers promoting end-of-life care discussions with family members over Thanksgiving. Paul Levy called it the first “medical blog rally on the Internet.” I wonder how many readers took the challenge?
I spent Thanksgiving with my sister (mom of 3) and brother-in-law in Michigan. After our dinner (with the kids tucked in for the night) we enjoyed a glass of wine and a game of Cranium (if you haven’t tried this game yet, you might want to pick one up in time for the next group of holidays – it’s like Pictionary, Charades, Trivial Pursuit, and American Idol wrapped into one). I looked for an opportunity to “pop the question” on end-of-life issues.
During a brief lull between rock song humming I casually inquired about whether or not my sister and brother-in-law had a living will. They said they hadn’t thought of it but agreed that it would be important to have one. We discussed various scenarios related to organ donation, end-of-life care, and cremation vs. burial preferences. Things degenerated a bit as I asked what their individual preferences might be for resuscitation under special circumstances (it was almost like a scene from Monty Python – “So, if you had no arms and no legs and you had a 10% chance of normal brain function recovery, would you like to be tube fed? How about if you had one leg and half an arm and a 5% chance of mental recovery? What about if you had 1/2 a liver, no spleen, and only one eye worked, but you COULD do math questions?”) We all had a good laugh at the black humor, but recognized that something important underlay the jesting. There is no doubt that we each had a 100% chance of dying at some point during our lives.
And then something unexpected happened – my brother-in-law looked me in the eye and said, “If anything happened to us, we’d really love it if you took our children and raised them as your own.”
I was very touched and happily agreed to do so. I replied with a wagging finger, “Now this doesn’t mean that you should take up helmet-free motorcycling…”
We all had a good chuckle and returned to Cranium, each feeling a little richer for the experience – we knew how we’d like to be cared for in case of critical illness, and I’d become the proud new godmother of 3.
November 30th, 2008 by Dr. Val Jones in Humor, Medblogger Shout Outs
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Dogs, as a general rule, do not like to be kissed on the mouth by drunk people.
– Edwin Leap, MD
h/t to Grunt Doc .
