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Satisfied or not, patients rate doctors online

01:00 AM EDT on Sunday, June 1, 2008

By Shari Roan

Los Angeles Times

Dr. Richard Fischel hired a lawyer after he says a patient posted “slanderous” comments about him online.


Los Angeles Times / DON BARTLETTI

Distraught over the results of cosmetic surgery on her nose, Katherine Chen did what many people do when they’re unhappy with a doctor. She consulted a malpractice lawyer and, a Lose Angeles resident, filed a complaint with the Medical Board of California.

But the 22-year-old college student didn’t stop there. Chen logged onto her home computer and wrote a tearful review about her experience, posting it to a Web site that encourages consumers to rate their health-care providers.

“I wasn’t nasty about it,” says Chen. “But I posted a comment about what I went through. These Web sites are useful. Doctors still have a lot of power.”

Chen and other consumers are trying to rein in that power. They’re saying what they think about the current state of health care and, more specifically, the doctors who provide it. Dozens of Web sites that permit people to rate, review, spin or flame their doctors have sprung up in the last year, operating in much the same way as online services that help people find hotels or plumbers.

Patients and site operators say the trend is good for consumers and good for healthcare. Thoughtful doctors, they say, will provide better customer service because of the feedback, and the bad ones will no longer be able to hideMany physicians say the reviews on RateMDs.com, Vitals.com, DrScore.com and other sites are skewed by disgruntled patients and are unfair, pushing some doctors to near-ruin after a single post.

“These sites don’t yield enough power yet to get bad doctors to change. And in the meantime, they may hurt good doctors,” says Dr. Phyllis Hollenbeck, a Washington, D.C., family physician and author of Sacred Trust: The Ten Rules of Life, Death and Medicine, a new book promoting patient empowerment. “It only takes one or two scathing comments and a doctor is put in a terrible position.”

The sites, more than two dozen of them, vary in their scope of information and efforts to be fair. But the trend is toward free, anonymous, no-holds-barred forums.

Some sites have grown out of existing ratings services. Five years after he started the hugely popular RateMyProfessors.com, John Swapceinski and his business partner launched RateMDs in 2004.

“You can find ratings on cars and flat-screen TVs, but it’s hard to rate professional services,” he says. “I think that’s overlooked.”

Angie’s List, a membership-based service that allows consumers to rate service providers, added health-care services in March. Angie’s List has recently expanded to Rhode Island.

The operators of Vitals.com, which launched in January, say their goal is to provide people with free, fair and balanced information to help them select a doctor.

“We think of it as something closer to Match.com, in which we want to match up patients with doctors who are right for them,” says Mitchel Rothschild, chief executive of the Lyndhurst, N.J., company.

The restaurant survey company Zagat has even teamed up with the health benefits company Wellpoint Inc., parent company of Anthem Blue Cross, to provide Blue Cross members with an online tool to evaluate doctors. The service allows members to issue scores based on trust, communication, availability and environment.

“Consumers can pretty much go on the Web and get information on anything, from what is a better shampoo to what is a better airline,” says Dr. Zeinab Dabbah, chief medical officer of Anthem Blue Cross. “We’re offering this to meet all of the expectations that consumers have about the marketplace.”

But viewing a doctor the same way as a product represents a dramatic shift. Once reverential of doctors, many U.S. consumers are more comfortable criticizing physicians, says Dr. Kevin Weiss, president of the American Board of Medical Specialties, an organization that sets performance standards and certifies doctors.

“There is a lot of pent-up frustration,” Weiss says. “Costs are going up, and people are paying more out of pocket. Plus, there is a lot of data now on how the health-care system needs to do better in terms of quality and safety.”

The tradition of doctors monitoring their own conduct through state medical boards and peer organizations is failing, Swapceinski says.

“There is a lot of protection for doctors,” he says. “Even with the state medical boards there is recognition that doctors policing doctors is not the best way to handle things. Most complaints about doctors are never made public.”

Chen says she did her homework — checking the doctor’s credentials and history of malpractice lawsuits and studying his Web site — before the surgery last year to shorten her long nose.

“It was minor,” she says.

She found no red flags in the surgeon’s background. The results of the operation, however, horrified her.

“I started crying. I didn’t recognize myself . . . I spent the next nine months at home. I was embarrassed to go out. I quit my job and dropped out of school.”

Chen says her nose was crooked and much too short, and that she was left with breathing problems and nose bleeds. She filed a complaint with the Medical Board of California, a process she later abandoned, and consulted a lawyer who discouraged her from filing a lawsuit because of the cost. She was also facing surgery to correct her nose. Ultimately, Chen says, she felt exposing the doctor on the Internet was her only recourse.

Later, pleased with her revision surgery, Chen also used a ratings Web site to write favorably about the doctor who performed it.

“I wanted people to know about my experience with him because he didn’t really have any feedback on the site,” she says.

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