In retrospect, it was the type of situation that doctor reviews were made for.
The indifference and impersonal feel of the doctor's office was turned all the way up to 11. It wasn't hard to feel like I was on some kind of assembly line, systematically hustled from one checkpoint to the next, with only minimal human conversation sprinkled in. After much waiting, I was placed into a small examination room, where I waited and waited and waited.
A doctor finally showed up, to my relief (I wasn't sure how long I had waited). The doctor asked me what was bothering me. I told him about my inability to breathe, the wheezing crackling sounds coming from my throat, the fevers that would break out. All the while he acted like I was boring him. So I finally stopped and waited for his prognosis.
He began probing me with his stethoscope on my chest, ribs, and back, asking me questions to which I'd already given him answers. And then out of nowhere, he asked me, "Have you been staying out late?"
"No," I replied. I was a 35-year-old husband and father of young kids at the time, which he would've known if he'd looked at my charts. I was also in a masters program. Nightlife really wasn't my thing anymore.
"Hanging out with girls?" he asked, with an awkward smile on his face.
"No, I'm married," I said, hoping this would subtly guide him to look at my personal information.
Instead, he pressed, with obvious incredulity, "So you're not hanging out with girls?"
I'm not sure if I had a reputation around town that I wasn't aware of; was there some Don Juan with a gossip-worthy nightlife posing as me? In the awkwardly close quarters of that examination room, I wasn't sure if I should try to figure out why he was accusing me of adultery or if I should just answer him with a right hook. Mercifully, the moment passed, he reminded me I was overweight, and he sent me away with a prescription for some antibiotics.
Years later, I'm still simultaneously puzzled and incensed by that strange visit. For sure, I wish I had posted a review for all to see, detailing the whole thing.
Few industries are as bad at customer service as healthcare is. In terms of delighting their customers, doctors are about even with the DMV. In fact, doctors seem to routinely fail to deliver the bedside manner that most of us have come to expect. And it doesn't seem like there's much we can do about it.
While social media and review sites have put restaurants, stores, and Fortune 500 companies at the mercy of customers, it seems like healthcare has gone the opposite direction, providing worse and worse care at higher prices. Few industries, it seems, could benefit from the influence of customer reviews as much as healthcare could. Of course, there is already a smattering of sites that let patients leave reviews about their doctors, and on social media, people can recap their doctor's office experience to their heart's content.
At the same time, however, the idea of using reviews and social media to put doctors in the spotlight might not be without its own problems. Instead of boosting the quality of healthcare, it might actually make the whole thing worse.
Here are six ways doctor reviews could help or hurt your health care experience:
This is the most obvious win for patients to be found in doctor reviews. In other industries, consumer reviews keep companies in line and help those companies improve where they are weak. Most importantly, reviews could give patients more power in the doctor-patient relationship-a relationship which is currently stacked heavily in doctors' favor.
In this way, an increase in the prominence of doctor reviews could introduce some much-needed free market principles into the healthcare system.
To be sure, reviews alone aren't a failsafe way to keep companies in line and help consumers make wiser purchasing decisions. In all industries where reviews are used-apparel, restaurants, vacation rentals, etc.-companies find a way to game the system in their favor. They pay to get more favorable reviews and to get rid of negative reviews.
When Angie's List first became popular, it touted its customers reviews as a way for consumers to weed out untrustworthy contractors and find the best ones. Sadly, this was far from the truth, according to Jeff Blyskal at Consumer Reports:
"[Angie's List] makes a big point to say they're consumer-driven, when in fact 70% of their revenue comes from advertising. It's not advertising Coca Cola, it's advertising from the companies they rate. While companies do not pay to be listed on Angie's List, companies can pay to appear higher up in the search results."
This phenomenon is already being seen in the few doctor review sites out there. HealthGrades, for instance, allows medical practices to pay for better and more prominent placement on their site. In fact, in many cases, revenue from medical practices is the biggest, and sometimes only, revenue source for these sites. Naturally, they're going to pull strings to make paying customers look better, minimizing or hiding negative reviews, and accentuating positive reviews.
For patients trusting review sites to give them unfiltered information about a doctor, this practice of gaming reviews only confuses patients more. Doctors' reputations are already fairly invisible. But if a site that claims to give unbiased reviews about doctors is actually making some doctors look better, even if they are actually terrible, then these review sites are doing more harm than if no review site existed at all.
This is the dark side of consumer reviews. While reviews can be used to expose the wrongs of corrupt companies, they can also, in the wrong hands, be used to destroy the reputations of perfectly good companies. You see this on social media, where a small group of vindictive, or just bored, consumers unite to wreak havoc on a blameless company or individual.
If reviews of doctors were to become a more mainstream practice, unfriendly patients could easily use this same power to ruin doctors' reputations. If, for instance, a patient was unhappy with their bill, they could fabricate a terrible story about their last doctor visit. The review would have nothing to do with the actual quality of the doctor's care, but it would have potentially devastating consequences.
Unfortunately, pretty much across the board, oversight on doctor review sites is almost nonexistent and quality control is not really happening. Yelp, for example, provides the same stars and text box for doctors as they do for street taco vendors.
If doctor reviews are going to work, there needs to be quality control in place to ensure that doctors are not being punished unjustly by false or overinflated patient reviews.
A recent expose by Consumer Reports found that literally thousands of doctors are currently undergoing disciplinary action from state medical boards. Their offenses range from practicing under the influence of illegal drugs to sexual misconduct to wrongful deaths.
Not that we patients would know.
This kind of information is not made public, and so patients are left with the task of contacting medical boards and other governing bodies to find out if their physician is trustworthy or not. Few would even know where to start, let alone how to penetrate the bureaucracy that holds this information. And so most patients go into a relationship with a new doctor blind to whatever issues that may have surrounded the doctor in the past.
This might be one of the most important positive results of more widespread doctor reviews. Instead of information about doctor misconduct being kept by a medical board, it would be available online with a simple Google search, where most consumers are used to doing their research.
In a heavy-handed effort to protect their reputations, many doctors began including so-called disparagement clauses into their paperwork. These clauses stipulated that, by signing on the dotted in fine print, patients agreed not to leave any negative reviews or comments online about their physician. More than a few patients didn't realize they had agreed to such a clause, left a negative review about their doctors, and soon found themselves being sued for breach of contract.
In one case, a patient found that his doctor had cost him thousands of dollars in costs because of an insurance paperwork error. The disgruntled patient, naturally miffed, took to Yelp and DoctorBase and gave the doctor one star. In return, citing the disparagement clause that the patient signed, the doctor threatened to sue the patient for $85,000 in damages and an additional $25,000 in damages for fraud until the review was taken down.
While legislation is currently in the works to protect patients from these types of lawsuits, we can only assume, in the meantime, that more doctor reviews would yield more lawsuits of this nature.
No one is going to pretend that customer service in the healthcare industry is any kind of shining beacon to the rest of the world. We all know it's bad. But perhaps one of the biggest potential dangers of reviews is the negative backlash they could bring to an already uncomfortable situation.
In other industries where reviews are plentiful, companies often end up locking horns with customers and even retaliating in the form of poor service or public defamation. But how this might manifest itself in the doctor's office could be even scarier than a ticked-off cable company or restaurant manager.
Imagine, for instance, that your physician does a poor job of seeing to your needs, and you leave a lackluster review about your visit. How might this affect the quality of their care next time you need them? Will they be slow to respond to your call? Will they drag their feet in getting test results back to you? Things get scary when your wellbeing is in the hands of a doctor who sees you as his enemy.
Obviously, the typical way of capturing and displaying customer reviews might not be right for healthcare. The cons-retaliation, lawsuits, ruined reputations-seem to outweigh the positives. So are there other ways patients can get the benefits of reviews without these risks?
The only reliable patient review system might be one that is run by the government, another impartial governing body, or a third-party licensing board. To be effective, these systems would have to be easily known and accessible to the public. The organizations behind them would have to monitor the reviews for accuracy, protecting patients and doctors alike from unjust retaliation.