Rate my doctor

Restaurants have toptable, teachers have ratemyteachers, and doctors are now to have views on them placed on the web at iwantgreatcare.org. This website has been designed to allow patients to rate their doctors for trust, listening and whether they would recommend them or not.

When I first heard about it, I reckoned it was a silly idea likely to die a quiet death were it ignored. Why do I think it’s silly? Well, feedback from patients can be very useful, but a website asking for only self selecting feedback (where extremes of views are most common) are hardly going to give a realistic view of how well a doctor is regarded by patients. That’s why when we do regular patient surveys, we ask all patients  seeing a doctor over a period of time to complete a validated survey. They may be still be anonymous questionnaires, but at least they will actually be real patients of the doctor in question – unlike an Internet site where anyone can pitch up and say anything, with no need to declare who they are. Doctors have no right of reply, due to duties to confidentiality. The website is touting itself as a fabulous service for doctors to find out what patients really think of them. I think it’s a very non-evidence based and possibly even dangerous thing.

Harold Shipman, if you recall, was very popular with his patients. Before he was convicted of murdering lots of them, I reckon he would have scored very highly on the popularity and recommendation stakes. Sometimes doctors practicing good medicine do things that are unpopular – for example, not using antibiotics for uncomplicated sore throats, or encouraging people with back pain to return to work. Sometimes psychiatrists detain people in hospital against their wishes – hardly something to do to improve your score at iwantgreatcare.org, but potentially life saving in someone who is seriously unwell.

But there’s more. Doctors are human. I can’t imagine that anonymous, untraceable criticism will have a beneficial effect on a doctors practice, but could cause distress that has serious consequences. 

But what makes me worried that this silly idea is being taken seriously is that news of this website appeared in the magazine GMC News. The General Medical Council regulates doctors. The GMC keeps telling us that plans for our re-validation to practice medicine will be announced soon. The owner of the site, a Dr Neil Bacon, wrote in GMC News “Why is it that PizzaExpress staff get better feedback on their performance than NHSdoctors?” But they are different jobs. And professionalism means doing things that are right, not things that are easy. Please could someone from the GMC reassure me that they are not abandoning science, evidence and professionalism for popularity and puffery?

It is clear from the website that Bacon has another agenda – that of selling on the collected data about doctor’s alleged popularity; as it says  ”use your hospital rating as a powerful marketing tool to patients”. Except, obviously, I would argue that the data they are currently collecting is so poor that it isn’t really worth having, never mind paying for.

And in any case who  really wants to recommend their trusted doctor to everyone else?  An appointment is hard enough to get already.

Margaret McCartney’s Blog

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A forum on healthcare policy and professional issues, by Glasgow-based GP and FT Weekend columnist Margaret McCartney.

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