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 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 website that encourages consumers to rate their healthcare providers. "I wasn't nasty about it," the West Covina resident says. "But I posted a comment about what I went through. These websites are useful. Doctors still have a lot of power."
Chen and thousands of other consumers are trying to rein in that power. They're saying what they think about the current state of healthcare and, more specifically, the doctors who provide it. Dozens of websites 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 the best hotels or avoid plumbers who overcharge.
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 hide. And, they add, why should doctors be immune from the trend toward better customer service?
Physicians aren't so sure of such reasoning. Many say the reviews on RateMDs.com, Vitals.com, DrScore.com and other sites are skewed by disgruntled patients and are thus 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 how they operate, their scope of information provided and their 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 turned to medicine, launching 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 dozens of types of local service providers -- painters, piano movers -- and then access those ratings, added healthcare services to its roster in March.
The operators of Vitals.com, which launched nationally 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 gotten into the act, teaming up with the national health benefits company Wellpoint Inc., parent company of Anthem Blue Cross, to provide some Blue Cross members with an online tool to evaluate their doctors. The service started in January and allows members to issue scores on a health professional based on specific criteria: 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."
An empowering tool
The ease of sharing information on the Web has given consumers a powerful hammer.
"The Internet is such a great tool for transparency," Swapceinski says. "In every profession there are some bad apples. In the medical profession, in particular, you really want to avoid them."
But viewing a doctor in the same manner as any service provider or product represents a dramatic shift in Americans' perception of healthcare. Once reverential of doctors, consumers today are more comfortable criticizing their 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," he says. "Costs are going up, and people are paying more out of pocket. Plus, there is a lot of data now on how the healthcare system needs to do better in terms of quality and safety."