How do you rate as a doctor? Anyone with a vague sense of intuition knows roughly how well they get on with their patients, backed up by the odd satisfaction survey and jar of homemade chutney. However, it surely won’t be long before we’re all at the mercy of online rating—a ‘Trip Advisor’ for patients seeking out the best doctors.
This is actually already happening to some extent. A website has been set up by patients in the US to help people find a good doctor. Contributors have to open a free account to prevent multiple postings from the same patients, and doctors can reply to any of the ratings given to them and, most encouragingly, the vast majority of listings are positive. Even critical comments tend to be constructive (or perhaps anything libellous is swiftly removed). However, non-libellous criticisms stay up on the site—a doctor has no right of removal but is encouraged to reflect on ‘what your patients think of you’. Some American doctors hate it, but far more of them enjoy receiving direct and swift feedback on their performance, something that happens regularly in just about every job. The exceptions are a few select professions, like GPs, where, until recently, self-regulation ruled the day.
The internet is, of course, a global phenomenon and the website in question has an expanding number of reviews of doctors and dentists in the UK. Ratings up to 5 (top score) can be given for ‘staff’, ‘punctuality’, ‘helpfulness’, and ‘knowledge’ with space for free text comments too. I now know that Dr ‘Rose’ ‘gives a personal service, you always feel like she listens to you, remembers you and genuinely cares about your health and well being. You may have to wait a while for your appointment, but when you get to see her you don’t feel rushed — she has time for everyone.’ Well done Rose!
The online rating of teachers is already pretty widespread in the UK. And why not? When I taught communication skills to students, I quickly learnt that the most useful bit of the training was the feedback given by the simulated patient. Very rarely do we get the opportunity to hear what a patient really thinks of us and yet how we consult is vital to our effectiveness as doctors. The more feedback the better, is what I say.
You may dismiss this as superficial, but online ratings are here to stay. NHS Choices (www.nhs.uk) has already added them to your practice profile for ‘How we perform’ (currently based on QOF1 2007 results) and ‘What patients think’ (from GP Patient Surveys2 for 2007), and my guess is that far more detailed, reliable and—dare I say it—useful patient feedback will soon be developed to aid revalidation (which may require personalised feedback from up to two hundred patients).
As a broadcaster and comic, I’ve always felt far more accountable than I am as a doctor. All my TV and radio appearances are scrutinised and often reviewed (not always kindly). And a comic is, after all, only as good as his last performance. If you don’t make people laugh, you don’t get bums on seats. So I welcome patient feedback. Not all of it will be great, but there’s always safety in numbers. If you can’t find 200 patients who approve of what you’re doing, you’re in the wrong job!
- British Medical Association. Revisions to the GMS contract 2006/2007: Delivering Investment in General Practice. London: BMA, 2006.
Please login to rate this article, view others comments or make your own.