Operators of the websites say that consumer feedback can improve relations between doctors and patients.
The operators of RateMds.com read every comment and delete ones that are "blatantly libelous," Swapceinski says. About 5% of the posts are taken down. Still, he admits, he gets threats from doctors' lawyers "on almost a weekly basis."
Some sites, such as Wellpoint's Zagat tool, will not post doctor ratings until at least 10 consumers have weighed in. DrScore.com, which was founded by a doctor, allows only numerical doctor ratings to be posted online -- no anonymous comments.
However, Swapceinski says his experience running RateMyProfessors.com convinced him that even a handful of rankings and comments typically bears the ring of truth.
"It's hard to prove it scientifically, but I truly believe that the averages are a reflection of what people think," he says. RateMDs.com attracts about 450,000 visitors a month and has 600 to 1,000 new posts a day.
But many doctors think most of the sites are of limited value and that consumers could be as easily led astray as informed by them.
"I wish I could say that this kind of forum will motivate the doctors who are jerks to change," Hollenbeck says. "But what you see is an awful lot of baloney on these sites, a lot of unedited venting. Feedback would be more useful when it tries to say what works and what doesn't work."
Physician organizations support evaluating doctors with empirical measures and making the information public -- as long as it's fair, says Dr. Nancy H. Nielsen, president-elect of the American Medical Assn. In January, the AMA released a statement urging consumers to ignore anonymous doctor rating sites, saying they "have many shortcomings."
"We are very concerned with how we serve patients," Nielsen says. "Many doctors use patient satisfaction surveys. Many insurance companies use surveys too. Doctors are comfortable with that. But we would like to see a turning away from the pointing fingers, laying blame, 'gotcha' approach."
To protect himself, Fischel recently signed up for services with Medical Justice, a Greensboro, N.C., company that provides doctors with contracts and services to guard against frivolous malpractice lawsuits. Last year, the company designed a contract doctors can use asking their patients to "respect their physician's privacy on the Internet" by not participating in online ratings.
If a contract is in place beforehand, a doctor can force a website to take down the offending material, says Dr. Jeffrey Segal, a physician who runs the company.
To a doctor, reputation is everything, Segal says, adding that doctors shouldn't bear the brunt of dissatisfaction with the faltering healthcare system.
"All stakeholders -- consumers, doctors and payers -- are frustrated right now," Segal says. "Because of that there is a lot of finger-pointing and a lot of anger, some of which is unproductive."
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shari.roan@latimes.com
