Aug. 30--Dr. Michael Gunter doesn't make a habit of haunting the ever-increasing universe of Web sites on which patients rate their health care providers.
But that doesn't mean the Las Vegas family practice and sports medicine physician isn't pleased -- and, maybe, a bit relieved -- to learn that people, presumably patients, think well of him.
Four points on Vitals. A perfect five on RateMDs ("best Dr. I have seen for years"). And a four-out-of-five on InsiderPages for Gunter and other doctors at Canyon Trails Family and Sports Medicine.
It seems odd at first, rating doctors, dentists and other health care providers like a food critic passing judgment on the local deli's BLT. But, in an online world in which everything from movies to plumbers to people's appearances are scrutinized, rated and critiqued, it also is inevitable.
Gunter is no stranger to the Internet. "I've had patients who have told me they've gone online and gotten my name and my school and my training, all of which is good. I think patients should do more research on doctors they see."
Gunter suspects that online rating sites may be simply a newer, more high-tech twist in the way patients always have found and evaluated doctors: talking with co-workers, friends and family members.
Patients always have come via "pretty much word of mouth," says Gunter, whose family and sports medicine practice also has advertised via radio, TV and magazine ads. But, he notes, "when you talk to patients and ask how they heard of us, it's always other patients."
Dr. Steven Fales, a Las Vegas family practice physician, also appreciates that online commenters on several sites give him good reviews. Still, Fales, who has been practicing medicine for 35 years, says such sites are "not a good source of information for patients," primarily because most of them are "so subjective."
One person's negative experience -- or, more accurately, one person's perception of a negative experience -- doesn't necessarily denote a bad doctor, says Fales, who notes, too, that patients may unfairly blame doctors for things that are out of their control, from a lab losing test results to a billing error by a third-party firm.
And, Fales says, if there is a problem, "maybe it was the patient. Maybe it was factors beyond anybody's control. A doctor can't overcome all of the factors that affect people's health care."
Certainly, any rating or review is only as good as the critic who wrote it. On some sites -- particularly those on which commenters may remain anonymous -- it's not difficult to find comments that are the functional equivalent of a child's tantrum.
But other sites strive to be more informational. For example, reviews on Angie's List are vetted by the site's staff, and each medical provider's critique includes a detailed questionnaire on which commenters break down an office visit into its individual components.
Founder Angie Hicks says Angie's List began in 1995 as a sort of backyard fence where members could offer other members leads on reputable plumbers, electricians and other service providers. In March 2008, Angie's List launched health care pages that offer members' recommendations for everything from acupuncturists to pediatricians.
Unlike many sites, comments are posted primarily by Angie's List members -- dues here begin at $2.60 a month -- who belong to the site. And, Hicks says, Angie's List addresses two primary concerns -- anonymity that allows consumers to allege nearly anything, and doctors' inability to respond to negative comments -- health care providers have with online reviews.
Reviewers on Angie's List are not anonymous, Hicks says. And, when a review is posted, Angie's List sends the doctor involved an e-mail alerting them that a review has been posted and, then, allowing the doctor an opportunity to post a response.
Hicks says Angie's List postings also are reviewed to prevent people -- disgruntled ex-employees or competing doctors, for example -- from trying to "game the system."
"We really focus on the integrity of the information that's on the list," Hicks says, "because consumers are willing to pay for good information and detailed information."
Safeguards or not, some health care providers would prefer not to be evaluated at all. Some, Hicks says, "are against it. They don't believe there should be an ability for them to be reviewed online."
Yet, she says, "consumers have been reviewing health care providers forever. It's just that it wasn't online, it was talking over the back fence. This word-of-mouth network is what many health care providers build their practice on."
The problem, says Shane Stadler, is that doctors' hands are tied in rebutting even patently untrue online posts.
Stadler is vice president of marketing for Medical Justice, a North Carolina-based company that offers guidance to its member physicians about preventing "frivolous lawsuits." According to Stadler, physicians are prohibited both by medical ethics and federal privacy laws from rebutting inaccurate, or even libelous, online postings.
Current laws hold Internet service providers harmless for information, even false information, they disseminate, so there's little incentive for a provider that hosts a review site to remove even an egregiously defamatory posting, Stadler adds.
As a result, Medical Justice developed a contract physicians can ask patients to sign that, Stadler says, stipulates, upfront, that the patient "not post on a Web site without the physician's consent, in exchange for more privacy guarantees."
It's not an across-the-board gag order, Stadler says. "We are not against feedback. What we want is good information. Currently, the way most of these sites are constructed, they are so flawed we feel it's bad for both physicians and patients."
Among those flaws, according to Stadler: small sample sizes, which can make a physician's entire rating hinge on only one or two posts, and the ability for competitors, ex-spouses and others with a personal interest to post negative comments.
The contract, Stadler says, serves primarily as a tool physicians may use in asking an Internet service provider to remove an egregiously false posting, but does not prevent the patient from, say, filing a complaint with a state medical board or initiating legal action against a physician.
Hicks, of Angie's List, opposes such contracts. "No patient," she says, "should have to decide between freedom of speech and health care."
"We want consumers to be aware that there are choices out there, and you don't have to sign one of these," Hicks says. "There's always someone out there who will provide care for you."
Granted, it's probably unwise for a consumer to take any single Web site or online review as gospel. Dr. Karen West, dean of the University of Nevada, Las Vegas School of Dental Medicine, says she views review sites "with a grain of salt," although she does use the Internet to seek out such objective information as a doctor's education, licensing status, background and office hours.
Otherwise, West says, "I really don't put a lot of stock in the reviews."
"I do think we like to feel in control of our health care. This is one avenue that allows us to do that," she adds, although consumers still "need to be cautious."
Dr. Susan Smith, a Henderson dentist, says patients sometimes tell her they saw a review of her on a Web site. But Smith adds that if a patient had any issue with her or her practice, she hopes they would tell her directly.
And, in nuts-and-bolts issues, a Web review can be helpful. For example, Smith once noticed a comment from someone who wished she had later office hours. That, in turn, prompted her to give the matter some thought.
"I'm sure they can provide you with some valuable feedback," Smith says, "and I also think they can be the source for some terrible repercussions."
Contact reporter John Przybys at jprzybys@reviewjournal.com or 702-383-0280.
-----
To see more of the Review-Journal or to subscribe to the newspaper, go to http://www.lvrj.com.
Copyright (c) 2009, Las Vegas Review-Journal
Distributed by McClatchy-Tribune Information Services.
For reprints, email tmsreprints@permissionsgroup.com, call 800-374-7985 or 847-635-6550, send a fax to 847-635-6968, or write to The Permissions Group Inc., 1247 Milwaukee Ave., Suite 303, Glenview, IL 60025, USA.
But that doesn't mean the Las Vegas family practice and sports medicine physician isn't pleased -- and, maybe, a bit relieved -- to learn that people, presumably patients, think well of him.
Four points on Vitals. A perfect five on RateMDs ("best Dr. I have seen for years"). And a four-out-of-five on InsiderPages for Gunter and other doctors at Canyon Trails Family and Sports Medicine.
It seems odd at first, rating doctors, dentists and other health care providers like a food critic passing judgment on the local deli's BLT. But, in an online world in which everything from movies to plumbers to people's appearances are scrutinized, rated and critiqued, it also is inevitable.
Gunter is no stranger to the Internet. "I've had patients who have told me they've gone online and gotten my name and my school and my training, all of which is good. I think patients should do more research on doctors they see."
Gunter suspects that online rating sites may be simply a newer, more high-tech twist in the way patients always have found and evaluated doctors: talking with co-workers, friends and family members.
Patients always have come via "pretty much word of mouth," says Gunter, whose family and sports medicine practice also has advertised via radio, TV and magazine ads. But, he notes, "when you talk to patients and ask how they heard of us, it's always other patients."
Dr. Steven Fales, a Las Vegas family practice physician, also appreciates that online commenters on several sites give him good reviews. Still, Fales, who has been practicing medicine for 35 years, says such sites are "not a good source of information for patients," primarily because most of them are "so subjective."
One person's negative experience -- or, more accurately, one person's perception of a negative experience -- doesn't necessarily denote a bad doctor, says Fales, who notes, too, that patients may unfairly blame doctors for things that are out of their control, from a lab losing test results to a billing error by a third-party firm.
And, Fales says, if there is a problem, "maybe it was the patient. Maybe it was factors beyond anybody's control. A doctor can't overcome all of the factors that affect people's health care."
Certainly, any rating or review is only as good as the critic who wrote it. On some sites -- particularly those on which commenters may remain anonymous -- it's not difficult to find comments that are the functional equivalent of a child's tantrum.
But other sites strive to be more informational. For example, reviews on Angie's List are vetted by the site's staff, and each medical provider's critique includes a detailed questionnaire on which commenters break down an office visit into its individual components.
Founder Angie Hicks says Angie's List began in 1995 as a sort of backyard fence where members could offer other members leads on reputable plumbers, electricians and other service providers. In March 2008, Angie's List launched health care pages that offer members' recommendations for everything from acupuncturists to pediatricians.
Unlike many sites, comments are posted primarily by Angie's List members -- dues here begin at $2.60 a month -- who belong to the site. And, Hicks says, Angie's List addresses two primary concerns -- anonymity that allows consumers to allege nearly anything, and doctors' inability to respond to negative comments -- health care providers have with online reviews.
Reviewers on Angie's List are not anonymous, Hicks says. And, when a review is posted, Angie's List sends the doctor involved an e-mail alerting them that a review has been posted and, then, allowing the doctor an opportunity to post a response.
Hicks says Angie's List postings also are reviewed to prevent people -- disgruntled ex-employees or competing doctors, for example -- from trying to "game the system."
"We really focus on the integrity of the information that's on the list," Hicks says, "because consumers are willing to pay for good information and detailed information."
Safeguards or not, some health care providers would prefer not to be evaluated at all. Some, Hicks says, "are against it. They don't believe there should be an ability for them to be reviewed online."
Yet, she says, "consumers have been reviewing health care providers forever. It's just that it wasn't online, it was talking over the back fence. This word-of-mouth network is what many health care providers build their practice on."
The problem, says Shane Stadler, is that doctors' hands are tied in rebutting even patently untrue online posts.
Stadler is vice president of marketing for Medical Justice, a North Carolina-based company that offers guidance to its member physicians about preventing "frivolous lawsuits." According to Stadler, physicians are prohibited both by medical ethics and federal privacy laws from rebutting inaccurate, or even libelous, online postings.
Current laws hold Internet service providers harmless for information, even false information, they disseminate, so there's little incentive for a provider that hosts a review site to remove even an egregiously defamatory posting, Stadler adds.
As a result, Medical Justice developed a contract physicians can ask patients to sign that, Stadler says, stipulates, upfront, that the patient "not post on a Web site without the physician's consent, in exchange for more privacy guarantees."
It's not an across-the-board gag order, Stadler says. "We are not against feedback. What we want is good information. Currently, the way most of these sites are constructed, they are so flawed we feel it's bad for both physicians and patients."
Among those flaws, according to Stadler: small sample sizes, which can make a physician's entire rating hinge on only one or two posts, and the ability for competitors, ex-spouses and others with a personal interest to post negative comments.
The contract, Stadler says, serves primarily as a tool physicians may use in asking an Internet service provider to remove an egregiously false posting, but does not prevent the patient from, say, filing a complaint with a state medical board or initiating legal action against a physician.
Hicks, of Angie's List, opposes such contracts. "No patient," she says, "should have to decide between freedom of speech and health care."
"We want consumers to be aware that there are choices out there, and you don't have to sign one of these," Hicks says. "There's always someone out there who will provide care for you."
Granted, it's probably unwise for a consumer to take any single Web site or online review as gospel. Dr. Karen West, dean of the University of Nevada, Las Vegas School of Dental Medicine, says she views review sites "with a grain of salt," although she does use the Internet to seek out such objective information as a doctor's education, licensing status, background and office hours.
Otherwise, West says, "I really don't put a lot of stock in the reviews."
"I do think we like to feel in control of our health care. This is one avenue that allows us to do that," she adds, although consumers still "need to be cautious."
Dr. Susan Smith, a Henderson dentist, says patients sometimes tell her they saw a review of her on a Web site. But Smith adds that if a patient had any issue with her or her practice, she hopes they would tell her directly.
And, in nuts-and-bolts issues, a Web review can be helpful. For example, Smith once noticed a comment from someone who wished she had later office hours. That, in turn, prompted her to give the matter some thought.
"I'm sure they can provide you with some valuable feedback," Smith says, "and I also think they can be the source for some terrible repercussions."
Contact reporter John Przybys at jprzybys@reviewjournal.com or 702-383-0280.
-----
To see more of the Review-Journal or to subscribe to the newspaper, go to http://www.lvrj.com.
Copyright (c) 2009, Las Vegas Review-Journal
Distributed by McClatchy-Tribune Information Services.
For reprints, email tmsreprints@permissionsgroup.com, call 800-374-7985 or 847-635-6550, send a fax to 847-635-6968, or write to The Permissions Group Inc., 1247 Milwaukee Ave., Suite 303, Glenview, IL 60025, USA.