Wednesday, August 19, 2009

A "statistically valid" physician rating site?

Another physician rating site has joined the din of online patient forums, but this one is taking a different approach.

The creator, Consumers’ Checkbook, says this site brings a more balanced assessment of each doc. Read more

Physician rating sites abound, and many of them just have a few entries from patients, making it easy for a couple rants or raves to skew the picture. Many docs say these sites are a disservice to patients – and a headache for the physicians – because the sample size isn’t statistically significant and can encourage patients to pick doctors based on factors other than quality of care. (Read more here about the sites – and how to defend yourself against this public forum.)

Consumers’ Checkbook (which AMNews notes here is the same group that in 2006 unsuccessfully sued the government for access to raw Medicare claims data for individual physicians) has completed pilot programs in Denver, Kansas City, and Memphis. The nonprofit consumer organization says their efforts show the approach can be scaled up nationwide.

Consumer Checkbook’s site relies on “scientifically valid surveys” of patients on information such as how well their doctors communicated, made themselves available, and arranged for a courteous staff - information the group says is "medically important."

They take a statistically significant number of surveys per doctor – such as an average of 58 completed patient surveys per doctor for more than 700 physicians in the Kansas City area.

“The rigorous survey design has enabled us confidently to identify real differences among doctors,” President Robert Krughoff said in a release on the group’s Web site. The group plans to do the survey in New York City this fall.

Does this sound like a more balanced approach to physician rating sites? Ever run into problems with rating sites, or do you have a solution to dealing with them?


  1. With so much focus on health-care reform, it is good to see greater openness 
regarding patient satisfaction and other measures of medical quality. Encouraging patients to rate their doctors online is good for the public and
 good for doctors. As the founder of, I believe that online 
ratings are most useful when doctors use that feedback to make meaningful 
improvements to the patient care experience. Unlike many online rating 
sites, DrScore is designed to empower patients to give their doctors
 feedback. Medical practices and health-care organizations use the DrScore
 survey program as an inexpensive and easy way to get feedback from patients.
 We eliminate the need for paper surveys or an outside firm that collects 
survey data, while providing quarterly reports that pinpoint specific areas
 for improvement.

    The patient's experience at the physician's office is one of the most 
important aspects of our health-care system in the United States, and
 doctors can only improve when they know which areas need improvement. That 
said, we have found that among the physicians who have acquired enough
 ratings on the DrScore site to be a representative sample (20 or more
 ratings), the mean score was very high - a 9.3 out of 10! In today's heated
 health-care debate, people sometimes forget that the patient-doctor
 relationship is essentially strong, and the majority of people are very
 happy with the care they receive from their physicians. A quality patient
 experience is an integral part of achieving the goals of health-care reform,
 and is one avenue patients and physicians can use to enhance medical quality.

  2. If you message me (Pam Moore knows how to get a hold of me), I can share my horror story with an unregulated physician rating site. Statistically sound data is the key. One disgruntled patient can destroy a physician's reputation with no consequences, just as product ratings on sites like Amazon can be manipulated by competitors.

  3. There is an interesting culture rift occuring on how physicians are "judged." On the one hand, we see an increasing demand for scientifically based medicine: you know, guidelines, quality improvement initiatives and so on.
    On the other hand, the push for more consumer focus means physicians are judged more by perception than science. Too often, these things are diametrically opposed. To take an easy example, the patient wants anitbiotics for a viral infection, the physician (being a good doctor) says no, and the patient dings her on a ratings site.
    Now, the work-around, of course, is for the physician to carefully educate the patient about why the antibiotic is not needed. But that doesn't always work either, and things get even more complicated when the evidence/science is less clear cut.
    Anyway, my point is that it's odd that right now the culture seems to want both: opinion-based and science-based medicine.