Better Health: Smart Health Commentary Better Health (TM): smart health commentary

Latest Posts

Why Physician Ratings Aren’t Quite Adequate Yet

“Most physicians are competent and able to take care of most of the problems patients present with.  The standards for getting into medical school are high and for getting out are higher.  I think this call for patients to become experts in picking their doctors is overstated.”  – David Rovner, MD, Professor Emeritus, Michigan State University

Most?  What does “most” mean?  Can most doctors treat me for the flu?  How about pancreatic cancer? Must I conduct the same type of research to choose a doctor to set my broken arm that I do to find one to treat my mom’s congestive heart failure?   Is the same level and type of research necessary to find a good surgeon as for a primary care clinician? Read more »

*This blog post was originally published at Prepared Patient Forum: What It Takes Blog*

Can Patients Choose A Good Doctor Online?

The following op-ed was published on October 27th, 2010 in USA Today:

When I ask new patients how they found me, frequently they say on the Internet through search engines such as Google.

Out of curiosity, I recently Googled myself. Numerous ads appeared, promising readers a “detailed background report” or a “profile” of me. Among the search results was information about my practice, whether I was board certified, had any lawsuits against me, and reviews from online doctor rating sites. Thankfully, most were favorable, but some were not.

Can patients reliably choose a good doctor online?

People already choose restaurants, movies, and their college professors based on what they read on the Internet, so it’s inevitable that many will research their doctors on the Web as well. But there are some good reasons consumers should be wary of the information they find online about doctors.

Random information?

An Archives of Internal Medicine study in September found that most publicly available information on individual physicians — such as disciplinary actions, the number of malpractice payments, or years of experience — had little correlation with whether they adhered to the recommended medical guidelines. In other words, there’s no easy way to research how well a doctor manages conditions such as heart disease or diabetes. That kind of relevant performance data are hidden from the public. Read more »

*This blog post was originally published at KevinMD.com*

9 Tips To Improve Patient Satisfaction

Some interesting points were raised at a recent Society of Hospital Medicine (SHM) session by Winthrop Whitcomb and Nancy Mihevc on patient satisfaction. To improve satisfaction scores:

1. Review the patient’s chart before you go in the room. It makes a big difference if the patient perceives you know what’s going on without having to bury your face in a chart.

2. Patients are often confused about who they are supposed to see after discharge. This, of course, is a safety issue as well as one that affects patient satisfaction.

3. Sit down when you are visiting a patient. Patients are happiest when they perceive you’ve spent enough time with them, and they are more likely to perceive this if you are sitting than standing with your hand on the doorknob. Read more »

*This blog post was originally published at ACP Hospitalist*

Patients Value Personal Recommendation Over Online Doctor Ratings

The organizations that rate hospitals and doctors have proliferated as the internet has become mainstream over the past 5 years. I’m sure you have seen some of these: U.S. World & News Reports, Consumer Reports Health, Health Grades, Leapfrog, Hospital Compare, Americas Best Doctors and 100 Best Hospitals. My local magazine lists the “top doctors” along with full page paid ads and promos that are very compelling. The questions is, do consumers care? Are these rating agencies really steering people toward top quality in health care?

Each of these agencies and organizations that “rate” have different measurements and criteria for their choices. The top rankings do not necessarily relate to quality outcomes. The Medicare data are two years old. Different treatments and conditions are judged, so a “top” hospital in one area may be a loser in another. Read more »

*This blog post was originally published at EverythingHealth*

Online Physician Ratings: What Is The Value Proposition For The Respondents?

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.


Latest Interviews

The Surprising Economic Burden Of ADHD (Attention-Deficit Hyperactivity Disorder)

If you can read this you need to download a more recent browser It is estimated that as many as million U.S. adults have ADHD Attention-Deficit Hyperactivity Disorder A recent research study publication-pending suggests that the economic burden of ADHD on America could be as high as billion annually. I…

Read more »

Is The Adderall Shortage A Harbinger Of Future Drug Supply Problems?

If you can read this you need to download a more recent browser Today most- if not all- Doctor’s offices are strained by the shortage of some prescription medication or vaccine. A month ago President Obama signed his executive order directing the FDA to take steps to reduce drug shortages…

Read more »

See all interviews »

Latest Cartoon

See all cartoons »

Latest Book Reviews

Book Review: The First Step To Improve Health Care Is A Close Examination Of How It’s Delivered

My friend and former Chair of the CFAH Board of Trustees Doug Kamerow has written a book that I think you will like. Besides being a mensch and witty as heck Doug is a family doctor and a preventive medicine specialist. In his new book Dissecting American Health Care Commentaries…

Read more »

“Your Medical Mind” Explores Factors That Influence A Patient’s Medical Decisions

Recently I had a conversation with Shannon Brownlee the widely respected science journalist and acting director of the Health Policy Program at the New America Foundation about whether men should continue to have access to the PSA test for prostate cancer screening despite the overwhelming evidence that it extends few…

Read more »

Book Review: Food Truths, Food Lies

Food Truths Food Lies written by family physician Eric Marcotte M.D. may be the most refreshingly evidence-based diet book of the decade. You will not find a single mention of super-foods magical berries or supplement must-haves in the entire book. What you will find is the cold hard truth about…

Read more »

See all book reviews »