Would a poor rating prompt you to consider changing doctors?
Posted at 5:00 AM on January 19, 2011
by Eric Ringham
(26 Comments)
Filed under: Health
One of Minnesota's largest health plans is launching an online rating system for doctors over the objections of the state medical association. Today's Question: Would a poor rating prompt you to consider changing doctors?
Comments (26)
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This is both street smart and inetlliegnt.
Poor Rating?
You mean I have a choice? I thought the DICTATES of my insurance company made that impossible?
I would move to a better doctor if given a choice, but often if they have worked with me and I have seen good results, I am not as worried.
Some doctors work in areas that are dictated by their arrangements with the insurance companies they work with. Often their rating can be affected by the conditions they themselves work in.
How about rating Insurance companies?
Charging more, offering less, and to top it off giving themselves pay raises and promotions to their board of directors/CEO's.
No, it certainly would not.
I would never trust a managed care organization to make these kind of ratings.
In fact, what a total waste of resources and money for an agency that accepts public money to focus on this!
i dont have a doctor but if i did i would try to get another opinion before deciding to change!
I trust my doctor of 2 years a whole lot more than I trust Medica with whom I have had a much longer association.
Ya, sure. I think so.
No. I cannot conceive of a system that would consider all the variables involved to make an evaluation meaningful.
Personally, the factors most important to me when considering a doctor is proximity to my house, affordable quality insurance, and the doctor's interest in recommending pre-emptive health habits. Doctors are not going to stop my death, but they can help me slow down my eventual demise.
I agree with Shane. A poor rating would affect my choice of a new doctor, but would not trump my own experience in an existing relationship. It would be really hard to have enough responses for any one physician for me to feel like it was a statistically credible measure, anyway.
Now a rating for a whole clinic system, where the numbers get bigger -- that might cause some movement on my part.
I don't have a doctor, I have friends that are doctors. I haven't had a doctor since 1983. If I had a doctor, I'd take poor ratings with a grain of salt. My vision for the future is humanity waking up and realizing we're not separate ... in fact our minds are inextricably linked and essentially one.
Healthcare, transportation, communication, education, work, play, rest, love, worship, creative expression ... everything will be experienced more completely and wholeheartedly than ever before. I hope you're not attached to private thoughts, there's no such thing, eventually that'll be obvious.
So, what is interesting to me (I am a physician) is that these stars are just "out there", and if one has the time and interest, one can dig in and figure out how the data was collected. But that's not what people do. And even if they do, this data is being represented as telling you what you care about (cost and qualilty)--but it really isn't--yet. I applaud the idea and the forward thinking of starting this work, but it ain't ready for primetime yet. Not in a useful, meaningful, and honest way.
Perhaps an analogy of how these oversimplified stars are arrived at might be the Zagat ratings of restaurants. What if your restaurant ratings were based on how much food is left over on the plate at the end of the meal? Is that how you want your restaurants rated? Does that tell you about the quality of the restaurant or chef?
I was pleased to see that my wonderful physician received a star for quality but not for cost effectiveness. I am glad the insurance company is not happy with how he spends their money but can't complain about the care he provides to me.
No. Doctor, is either a Doctor, or he or she, isn't. Doctor isn't something, that is to be checked, see if it's worth, the price, like one is shopping around, let's say, clothing, shelter, or insurance plan. Everything else is fine. But, when it gets to Doctor, that's where all shopping around and looking for a bargain, stops. One, is either is a Doctor, or not. More so, how can a sick person, for that's when one needs a Doctor, or his or her kinships, they not in a very better condition, to judge bad or good, is in a position, to rate Doctors, or decide which one to pick, lest in a very Healthy time of Life. What a worldly person know about intricacies of Medicine or special branches of it, to judge whether one Doctor is better, than the other, not only that, pricewise? One gives all one's got to a Doctor, can he or she monitor or check every now and then, how's the Doctor doing, during the treatment, even a treatment that takes relatively long time, say convalescence, or recovery from a major operation? And, if one makes a switch, is one that profficient to be sure that this time around, contrary to the last, the better choice is Finally made? And one is now really sure that one is in good hands, and no need to check and rate, any more. From the conception of Medicine as a profession, spawned from a branch of philosophy, the one responsible for that, Hypocrate, demanded his apprentices to take the Oath, which other branches didn't require, that above all don't harm. That is still intact, as far as Medicine is supposed to go by that definition, unless it's object or purpose or its mission, or manhood philosophy has changed or modified, or maybe eroded. And, if it has, then that's right, we'll go shopping around, taking rating as a measure, best choice available given the present situation.
This is a really bad idea. And it should embarrass anybody at the company involved who knows anything about data collection. The information will be worse than useless. Relying on a self selected population of reviewers to rate doctors creates too many problems of bias to list here, but suffice it to say nobody should trust these ratings. Unfortunately, people will, and real harm will be done as a result. Not least among those suffering harm will be the doctors criticized by unhappy patients who may simply be prone to complain or who don't know the first thing about what makes for good, or bad, medical care. As someone who taught intro epidemiology (a study design course) at U of M for many years, I can tell you that a student submitting this as a proposed design to evaluate doctors would have received a grade of F. Or perhaps F-.
One only needs to look at the poorly thought out and clearly mistaken product ratings and reviews on Amazon.com to see that the ratings from a system like this is going to be very questionable. The involvement of an insurance company also makes me wonder what sort of editing and censorship is going on. No, I would not change doctors on the strength of these ratings.
I think most people can tell right away on their own whether a doctor is a good fit for them. I based my choice on a new doctor when my insurance changed last year on the care system the clinic I chose was in, and figured that if I didn't like the doctor I was assigned, I could easily change doctors within that care system. "Knowledge is power" but a rating on a health insurance website is not going to be my final determining factor on whether I choose to see a particular doctor.
A poor rating wouldn't automatically make me change my doctor. Other people being dissatisfied doesn't affect if I am happy. If I was unhappy it might help convince me I'm right and encourage me to find a new one. The greatest effect it would have is to discourage me from picking a poorly rated doctor in the first place.
I suppose if I didn't live in rural America but in the Metro where there is a perceived choice. Rural medicine reminds me of the BIA where there is a reason that these people work here and it's not good.
What I don't hear being asked enough by consumer and the media is "Where did this data come from?" It is based on prior insurance claims, and I believe as far back as 2008. I think there is much that we as health care providers and consumers can learn from this data--and that it is a good first step. However, it is by no means ready for such an oversimplified "star/no-star" system.
If you want to learn more about the accuracy of claims data, read the story of Dave deBronkart, aka e-patient Dave:
http://epatientdave.com/about-dave/
It would make me ask more questions to my doctor, my clinic, and my insurance company.
After asking more questions, it might.
If it makes us better consumers of medical services, I think this is a great service. But of course, you are only going to get out of it what you get into it.
We need better marketplace solutions to health care. This is a good first step.
How would that system rate a physician who tells an anxious patient, "I'm not going to order a CT scan, because the very remote chance that it might show something that would help me treat you better is more than outweighed by risk from the radiation it would expose you to"? What about the doctor who says, "Antibiotics won't help you, and if I prescribe one, it would only contribute to the rise of resistant strains of dangerous germs"? Or, "That expensive drug you saw advertized on TV is no better than this older one that's available as a generic"?
Probably not, especially since it is the insurance company doing the rating.
Maybe the docs and their staff who have to deal with the insurance companies on a daily basis can all get together, rate the insurers, and do their own website.
A poor rating wouldn't make me consider changing my physician. My interaction with that physician would make me consider changing.
However, a poor rating would make me consider not choosing a new physician. Though I agree with the previous comments that a number shouldn't be a determining factor, especially considering how subjective patient-physician interaction is, a poor rating may make me think twice. What would be more informative would be a treatment outcome rating.
As a teacher, I know how wrong it is to use one number to judge anyone. There's evidence that the system has mistakes and doesn't accurately take into account variations in the types of people each doctor treats. We need to stop thinking we can reduce everything to a simple number - it's not an effective way to judge students, teachers, and certainly not doctors.
A poor rating would not necessarily prompt me to change doctors. As I have found out with other online evaluations by consumers, there are some people whose expectations are very different than mine.
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