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.
"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.
And it's not just insurers, but patients who are judging doctors.
Second Opinion: Medicine Online
Read part I | Part III
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.