Sue Gyford: Is online doctor ratings site healthy?

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A way to restore people power to healthcare, or a chance for net bullies to have their say? Health Reporter Sue Gyford looks at the latest online ratings website

IT has become the way we choose our books, plumbers and even our holidays, but can online ratings for doctors and hospitals lead to improvements in our healthcare? Or do they just give a public platform for disgruntled patients who want to lash out at health workers?

Some fear that websites for rating doctors are unreliable and unnecessary.

In 2008, 21 reviews were submitted to the US-based site rateMDs.com about a Manchester doctor. They included “the nicest doctor I’ve ever met” and “superb bedside manner”. There was a hitch, however – the reviews were spoofs and referred to Britain’s most prolific serial killer, Dr Harold Shipman.

Not surprising, then, that the most prominent of the UK-based sites, IWantGreatCare.org, is keen to emphasise its reliability and credentials.

It recently announced that it had appointed former Health Minister Alan Milburn as chairman. As well as its public ratings website, it runs a consultancy, working with the NHS and private companies to offer structured feedback on healthcare. Among its clients is Stafford Hospital, where it is attempting to restore standards and reputation after a public inquiry found that hundreds of patients had died unnecessarily because of inadequate care.

The site’s launch caused an outcry among medics, who said that assessments of their care should be done in a structured, objective manner rather than as an online free-for-all.

The website was also forced to take down some reviews in its early days after being sent a formal warning by libel lawyers.

Dr Dean Marshall, chairman of the British Medical Association’s Scottish general practitioners’ committee, says: “For the average doctor or GP, it’s not had any impact that I’m aware of and our position’s still the same. It’s not clear what use it is to patients, who in the main don’t have the ability to choose any doctor in the country.

“Also, there are other bigger issues that the comments only relate to one episode of care for one doctor, rather than the wider picture. Of course, if I’ve just turned down a patient for a sick line, or a particular drug they want, they are not going to be disposed to give me a good review.

“All GPs carry out patient surveys, and every practice has a policy or process for dealing with patient complaints, and if people are unhappy with their care they can complain to the General Medical Council.”

The main site at IWantGreatCare.org was set up by Dr Neil Bacon in 2008 and gives anyone with 90 seconds to spare the chance to submit a review of their doctor, dentist, pharmacy or hospital. Visitors are asked to give a percentage rating for different categories, which are shown individually and combined to create an overall percentage rating.

Ratings are made anonymously and the website pledges to post them unedited, but will moderate any that are reported as abusive or unfair. Doctors have the chance to respond to comments online.

NHS Lothian is also sceptical about the use of ratings websites, saying it prefers to use its own avenues for patients to express their opinions. Nurse director Melanie Hornett says: “Patient feedback plays a key role in the ongoing improvement of our hospitals and services. However, we would prefer that patients gave us their feedback directly and we have a range of options already available for them to do this.

“All patients coming into hospital for a planned appointment are sent a comment form and pre-paid envelope as part of their information pack and the majority will be asked to complete a questionnaire about their care when they are discharged. We also have questionnaires and a suggestion form on our website to encourage patients, their families and carers to help us improve the patient experience.”

IWantGreatCare.org spokesman Joshua Van Raalte points out that the NHS’ own feedback isn’t revealed to the public in detail, unlike the reviews on its site. The NHS site, NHS Choices (nhs.uk), gives patients in England the chance to post feedback about their GPs online, but only at a practice level, rather than individual doctors.

Mr Van Raalte says: “We’re so used to putting up reviews for things on Amazon, eBay and TripAdvisor that it’s lagging behind a few years for healthcare. It will take off and we have to make sure that it’s done right.

“In the four years we’ve been running, I think 97 per cent of feedback has been positive. Originally, some doctors said this unfair criticism was going to happen, but most people are positive because they are passionate about the good care that they have received. There are mechanisms in place if there is a negative comment. The procedures are there to inspect posts and remove them if they are not quite indicative of the true experience.”

What kind of things do people say about Edinburgh doctors online?

The good

“An amazing man, he saved my life as I was seriously ill... Always honest and very caring towards his patients. A physician of EXCEPTIONAL character. He is honest, open and will actually explain your condition and options to you.” – About David Bartolo, surgeon at the ERI, on ratemds.com

“Wasn’t meant to be my surgeon but he did a good job and my scars are minimal.” – About Andrew De Beaux, surgeon at the ERI, on IWantGreatCare.org.

“Following a complex reverse geometry shoulder replacement, I cannot praise this doctor’s skill enough.” – About CM Robinson, surgeon at the ERI, on IWantGreatCare.org.

The bad

“This Dr ruined my life.” on IWantGreatCare.org

“Did not take my condition seriously enough which resulted in long term complications.” on ratemds.com

“While initially she appears to be a caring concerned GP, in time she proves that to be a front.” on ratemds.com