An article in Thursday's Wall Street Journal reveals a first in the New York City region: a doctor-rating online tool now being posted by the North Shore-LIJ Health System. According to Corrine Ramey's article, only a very few other U.S. hospitals or health groups have gone in that direction. The first to do so was the University of Utah Health Care in 2012, with now only about five others following suit.
Is this going to be good for patient care, or will the spread of patient/consumer ratings of doctors become an oppressive extra concern for already-overworked physicians, with more and more patient care issues, as well as paperwork burdens, thanks to the ACA/Obamacare? And then there's always the omnipresent dread of predatory lawyers seeking derogatory comments, as a clue to identifying dissatisfied patients for the purposes of converting them to potential clients in frivolous lawsuits, thanks to such reviews.
When I was in practice in the 1970s, and subsequently through 1996, I was on staff at both North Shore and LIJ (quaintly known then as Long Island Jewish Hospital), when they were not only separate hospitals but fiercely competitive. The mega-merger trend has led to massive consolidation of these previously independent hospitals into "health systems" across the nation. This sea-change is not driven by a motivation to improve patient outcomes, or render more compassionate and conscientious medical care. No--it's driven by market forces, i.e., follow the money.
Just absorb these thoughts and you decide:
Hospitals say posting their own ratings increases transparency, provides useful information to patients and helps them compete in a marketplace dominated by commercial sites such as ZocDoc, Yelp, Vitals, Healthgrades and RateMDs.com, that, after all, are already publishing doctor ratings.
Words like "...compete in a marketplace..." should illuminate the real motivation behind such "doctor report cards." As I said the last time a similar issue was discussed here one month ago, "Grading, quality assessment, and report cards for professionals are one of those things that sound great on paper, but often not so much so in practice. It s simply too difficult to reliably and objectively evaluate some things."
And then, from the Journal article, there's this doozy:
"'We want to become the honest broker of information that we think you ll find helpful,' said Ira Nash, senior vice president and executive director of North Shore-LIJ Medical Group, the hospital s physician practice."
I see: the hospital excuse me, the Health Care System is going to be the "honest broker," apparently by rating their own docs and publishing their own ratings for them. That sure sounds honest to me, and "transparent." No, not really.
Doctors' competence, compassion and even more objective data such as outcomes cannot be assessed by a Yelp-like rating system. Such important evaluations cannot be analogized to consumer ratings of washing machines or personal computers. I have worked closely with MDs over the years and frankly, I would find it difficult to quantitate many of their professional attributes if I had to. And, I wonder if the patients' comments are actually rendered by patients themselves, their family members, or random strangers who possibly have some axe to grind.
This is a bad idea and I can only hope it will wither away, but given the "market forces" we seem to be dealing with everywhere these days, I fear it will grow. Bad for doctors, bad for patients.
But good for the "health care system's" bottom lines.
