Don't even bother with Web-based doc-rating systems.

Health and medicine explained.
Nov. 28 2008 7:05 AM

Doctor, Doctor, Give Me Reviews

Don't even bother with Web-based doc-rating systems.

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After paying for six additional HealthGrades searches to provide deep background on other members of my select group and finding nothing at all, I gave up. The paid sites appear every bit as lean as the freebies.

A confession before moving on: I was reviewed on one of the freebie sites, DrScore.com—and, um, someone out there doesn't like me. All of my measures fell short—my exam, timeliness, treatment, even my staff. So I did what any normal American male under e-assault would do. I stuffed the ballot box. I pretended to be a patient of mine and lied about my age, gender, how often I see me, and the reason I was seeing me. I talked up my friendly attitude and thoroughness, gushed over the oodles of time I spent examining me, and declared my overall treatment a success. Not to limit the kudos, I also gave high marks to parking availability by my office. Then I did the entire drill a few times more (changing my age and gender once or twice, natch).

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With my unceasing selfishness campaign, I was able to hike my scores to levels that would make my mother and even my mother-in-law proud. I also peddled my influence upon one other site, Suggestadoctor, where my electioneering was particularly productive. The next day, I received an e-certificate in a gold frame announcing that patient Kent S. had rated me so favorably—he was particularly impressed by my "superhuman ability"—that I was now a "Suggested Doctor" though I didn't make it into the site's elite "Most Recommended Doctors" circle.

What can we make of a system that seemingly addresses a topic of such central importance yet remains 99.99 percent content-free (and so easily manipulated)? Compare the feckless rate-a-doc sites with eBay, with its well-maintained system of checks and balances. Thousands of comments from previous buyers accrue to eBay sellers, and if you've ever bought on eBay, you know the seller comes at you to fill in your evaluation! with the ferocity of a prison guard.

There's the difference. On eBay, each side of the equation—the buyer and the seller—wants to get the skinny on the other. In contrast, rate-a-doc sites have no clear constituency. Doctors aren't involved in policing the sites (unless they're padding their scores) and don't beg their patients to fill out the forms, and patients don't seem particularly itchy to click through sites that few have ever heard of (except, perhaps, the people who also call in to talk radio). And in the interest of fairness and self-aggrandizement, may I say that it is likely that the patient ratings skew south—probably only those with a serious ax to grind have any interest in hacking through the endless questionnaires. But if the doctor visit works out well, who would bother?

Even accounting for the inevitable bias, we are left to ask what value two, three, or even 10 or 20 comments about a doctor can have. The entire enterprise is yet another fine example of what happens when the lure of potential advertising dollars takes the lead and the content of interest (does your doctor suck?) is just along for show. No one at the sites is really worrying about your doctor—they're just concerned with keeping the sites afloat. So unless you're looking for a place to order a weight-loss shake, I suggest you click elsewhere.

Kent Sepkowitz is a physician in New York City who writes about medicine.