Fighting Back Against Nasty Online Reviews

Wayne Guglielmo, MA


March 22, 2011

In This Article

Rating Sites That Are Good

In Dr. Bagley's own Kansas City, for example, local grantee Quality Health Together assesses, among other things, how well the area's primary care practices are managing asthma, as measured by the percentage of their patients receiving the right medication. Two practices -- Johnson County Pediatrics and Pediatric Associates of Olathe -- scored 100%; 3 practices -- Creekwood Family Care, Encompass Medical Group, and Gashland Clinic -- scored significantly below the Greater Kansas City Area average of 92%.

"These scores are all derived from claims data, not clinical data from the chart," says Dr. Bagley. "But within this limitation, what Quality Health Together and other grantees are doing [in regard to quality measurement] is a start."

He's also encouraged by efforts such as Consumer Reports' joint project last year with the Society of Thoracic Surgeons to rate the nation's top heart-bypass surgical groups and publish that data online, as well as in the magazine; UnitedHealth's Premium Designation program, which recognizes doctors and specialty centers that meet or exceed both quality of care and cost efficiency standards; and by Medicare's own Physician Compare online tool, a work-in-progress that some think could end up setting the standard for other rating systems.

What's the Right Balance?

At present, the online balance between useful and marginal physician information -- between considered opinion and defamation -- is continually shifting. As the public demands more and more transparency in healthcare, that balance may inevitably tilt in a positive direction. And not just in the area of quality ratings. Increasingly, the public wants other credible information posted online about physicians, including their standing in the profession. Medical licensing boards, for one, have responded to this demand.

"At some of our annual meetings, the most well-attended sessions have been about how better to outreach to the public," says Lisa Robin, senior vice president of the Federation of State Medical Boards. Currently, all 70 Federation of State Medical Boards member boards have made some version of a physician profile available to the public online.

One of them is the North Carolina Medical Board, which in December 2009 began posting enhanced information about its approximately 30,000 licensees, including malpractice/professional liability payments, felony convictions, certain misdemeanors, certain hospital privilege actions, and actions take by out-of-state medical boards and other health regulatory agencies. (Posting criteria -- which includes a 7-year period beginning May 1, 2008 for malpractice/professional liability payments -- have been established by state statute.)

"The option to look up a licensee is the most popular feature on our Website, says Jean Fisher Brinkley, the board's director of public affairs, whose department verifies the accuracy of all self-reported information. (That added step isn't required by North Carolina law.) As for the licensees themselves, says Fisher Brinkley, "I still hear some grumbling, but there have been no major complaints."

This, then, is the brave new world for physicians -- a world in which their patients will increasingly seek them out online to assess their reputation and standing in the profession. The big trick now, to paraphrase Medical Justice's Jeffrey Segal, will be to ensure that this transparent system, whatever shape it ultimately takes, is truly useful to consumers -- and scrupulously fair to doctors.


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