Can You Trust Online Doctor Rankings?

CBS Evening News: Insurance Companies, Individuals Chime In Online; Should You Listen?

(CBS)  For years, Ved Kawatra had excruciating pain in her shoulder: arthritis had taken its toll. Medications, therapy, nothing worked. She needed a total shoulder replacement. To choose an M.D., she and her husband turned to their PC.

"We decided to go on the Internet and look for surgeons, doctors who do shoulder replacements," said Ved's husband, Mahendra Kawatra.

Finding a surgeon proved difficult and confusing; first of all, there was an overwhelming amount of information. But there was also something the Kawatras had never seen before: The doctors were rated by their insurance companies, reports CNN's Dr. Sanjay Gupta, a CBS News contributor.

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Read more from our partner in reporting this series, BusinessWeek.

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A growing number of insurers are placing doctors into different levels or tiers. The higher the tier, the more the company will reimburse. A patient might have a co-pay of $35 to see a Tier-3 doctor, but would pay just $15 to see a Tier-1 doctor.

"I have no concerns with rating the doctors as long as I should know, the patient should know, what they are being rated at," Kawatra said.

She makes a good point. One Web site uses stars to rank doctors and it's clear which doctors score highest. What's not clear is why. Patients often don't know and many physicians say they, too, have no idea how they're judged.

"What we don't like is when the tiering system is used that is not transparent, that we cannot see the data, we can't understand how it was created," said Dr. Richard Parker of Beth Israel. "And frankly, we can't understand why we were put in the tier we were put in."

Parker says he's in fact ranked differently from plan to plan, which is frustrating and confusing.

Insurance companies say they rate doctors based on quality and cost.

"That sounds very good. The problem is quality is very hard to measure," Parker said. "If a diabetic patient has his or her blood sugar measured several times per year, that's easy to measure. But many of the other things that patients come to the doctor for are just not easy to measure."

"The bottom line is that the only way for things to get better is to measure them. If you don't know how well you're doing, you have no way to see over time if you're improving or things are getting worse," said America's Health Insurance Plans spokesperson Susan Pisano.

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Second Opinion: Medicine Online
Read part I | Part III

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And it's not just insurers, but patients who are judging doctors.

On DrScore.com, patients can rate things how their doctors treat them, as well as the staff and punctuality. BookOfDoctors.com asks patients 14 questions to rate their doc. And RateMDs.com allows patients to both grade their doctors - and add their own comments.

In the end, the Kawatras chose not to go with the doctors recommended by their insurer, but instead relied on their own online research.

[sfeldman5]

When the Kawatras researched doctors online, they faced a plethora of doctor ratings, rankings and rantings. I created DrScore.com, a site specifically developed to enhance the quality of patients%u2019 healthcare experience.

DrScore.com helps doctors get valuable feedback from patients and lets patients freely get information about doctors. Nearly 1,000 doctors around the country support use DrScore to get feedback from their patients. DrScore patient satisfaction reports provide doctors a wealth of information about their practice, information they use to improve their services. As a practicing dermatologist, feedback from my patients was tremendously instructive in helping me strengthen patient relationships. I think all of our participating offices would agree wholeheartedly that the feedback from our patients is critical to our success as doctors.

Plus, consumers like the Kawatras can easily access DrScore.com at no charge and see overall ratings for physicians searchable by name, zip code and/or specialty. Our database also includes basic information about more than 800,000 physicians nationwide. DrScore.com maintains physician ratings for all doctors in our database, not just those who pay to receive our reports. To help keep our data up to date, patients can add physicians who aren%u2019t in our database.

Doctors and patients want the same outcome %u2013 to get better. DrScore.com helps doctors and patients collaborate on the path to good health.

[gasmask1]

You can bet if the Insurance world is involved there is a crime being committed.

[timothyone-2009]

Doctors who do fewer expensive procedures are rated higher. It''s not about quality, but about money, money, money, money, money, money, and more money! Oh... I forgot... it''s also about cash!

[brainteaser2]

No you cannot trust online doctor polls. They are a combination of popularity contests and more meddling by insurance companies. There has to be an element of trust in a doctor-patient relationship

[whatabreeze]

No disrespect to anyone at CBS (you truly are my favorite) but why on earth would anyone consider an on line physician when there is just as much positive and negative in the open field. You can see what your getting and in regard to the monetary issue, there is "Always a cost in doing business." G-d Bless...

Breeze and Franky "Boston Terrier Neuro Service Companion."

"Founder, Central Pontine Myelinolysis Foundation"

[earache4]

Can You Trust Online Doctor Rankings?

I sure hope so! I built my whole Fantacy Hospital League Team based on those rankings!

[lasikexpert]

I work with a nonprofit patient advocacy that evaluates Lasik doctors based on a detailed patient survey. To attain certification by our organization, Lasik surgeons must be in the top 90th percentile of their peers. We make the survey available online so all may see what we ask patients.

Transparency with any healthcare provider evaluation is required. The needs and motivations of one group may not be the same as another. A patient may not be the least bit concerned if a doctor is the most cost effective, but would be very interested if the doctor%u2019s results are among the best.

Evaluating healthcare provider outcomes can be very challenging and tends to be an unwieldy and expensive process. Someone will need to pay for that process and ultimately it will be the consumer. This creates a strong disincentive to participate in any broad evaluation program.

For better or for worse, it seems that the primary process by which poor doctors are identified is malpractice litigation. Even that can be an inadequate yardstick as many will pay off a small amount as a nuisance, yet the records still show a successful malpractice claim.

Proactive healthcare provider evaluation is a difficult process fraught with limitations, however informed patients demand this kind of analysis and industry, or nonprofits such as ours, needs to provide healthcare consumers with this information.

Glenn Hagele
Council for Refractive Surgery Quality Assurance
www.USAEyes.org

[tngreen]

I would tend to be most wary of those doctors who received high ratings from insurance companies, because it would tend to indicate that they put keeping costs down above patient well-being. I would much rather see a website where patients themselves rate their doctors on accessibility, listening skills, knowledge, performance of the doctor''s staff, and such. The interests of insurers is usually at direct odds with those of patients--maybe we should use these sites to identify doctors to AVOID.