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Rating your doctor

September 3, 2009
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When it comes to doctors, their aura splintered a long time ago in the developed west, but an USA based rating site by the name of ratemds.com has helped remove any doubts. The site allows patients to rate their doctors, online. The site has already rated 204,224 doctors till today and seems to be going strong as they get about 800 new ratings per day! And guess what, India is on it too, besides the USA, the UK, Canada, Australia and New Zealand.

The rating can be good, average or poor, and the docs are to be rated on four aspects:

  1. Staff – How is the service and helpfulness of the doctor’s staff? (This category is NOT included in the “Overall Quality” rating.)
  2. Punctuality – How long does the doctor keep you waiting? (This category is NOT included in the “Overall Quality” rating.)
  3. Helpfulness – This category rates the doctor’s helpfulness and approachability. Is the doctor approachable and nice? Is he rude, arrogant, or just plain mean? Does he have a good bed-side manner?
  4. Knowledge – This is the most important of the three categories, at least to most people. How did his treatments work for you?

Well, doctors will be happy to know that their punctuality or the behavior of their staff is not taken into account. But their helpfulness is. If I think back to the best doctors I ever had, a doctor’s persona does count. If the patient feels comfortable with the doctor, it makes communication easier and this helps in diagnosis and treatment.

But rating doctors is a sensitive subject which some people (particularly those from the medical field) feel isn’t right. They feel that patients should not rate doctors because they do not know medicine. There is also the possibility or abuse or vindictive patients on such sites.
However there is another point of view. That like other professionals doctors provide a service and this service needs to be rated. More so, because it can be a case of life and death for patients. And that abuse can be controlled with good management by site owners.

On this site for example, they filter out abuse and warn:

Please make your comments detailed, helpful and polite and tell us WHY you rated as you did. Libellous or very short comments may be deleted. Further, this is not the right forum for reporting illegal activity, unless you include a link to a site with supporting evidence.
And remember, you are legally responsible for what you write here.

Also if too many negative comments about one doctor arrive within a short span of time (even if they are from different computers) then the site management becomes suspicious and such comments are strictly checked before they are published.

I am not sure however whether libel laws will work that well in India. As it is our legal system is slow to react. Perhaps that is why even doctors don’t have too many malpractice suits against them. And if they do have, most of the doctors win. As it says here:

Regulatory bodies, such as the MCI and state councils, constituted to look into matters of negligence…maintain that most cases do not constitute medical neglect. “Almost 90 per cent of such cases happen because of lack of communication or error of judgment. Since the patients who visit private hospitals spend enormous amounts of money, they believe that nothing should go wrong,” says Dr Saini.
Doctors argue that medical services can’t be equated with the service industry which promises value for money. “Medical errors are different from other professional errors because we are working on the human body. There is no exact procedure or set formula to reach a conclusion, so errors are bound to happen,” says Dr Saini..

Well, I am sure that medical treatment is a very complex procedure, but it is difficult to generalise. I do not have a list of actual cases and judgments so cannot evaluate that here. But I have read that more often than not, the doctor is viewed sympathetically.

In India a ratemd site will be useful as the legal route doesn’t work that well. In any case, why go to a court after the damage is done? A rating site helps patients choose a doctor most suitable to them. Mobility has increased in India and thousands are leaving their birthplaces and the first thing they need after reaching the new place is a good doctor. A person has to frantically call up someone who knows someone who knows someone who knows a doctor. That is the only way. Few of us like to walk into a doctor’s clinic without knowing at least a little something about him.

The truth is that every doctor, however competent he is, will have at least one or two disgruntled patients. That doesn’t mean that the doctor isn’t good. If I read 10 good reports about a doctor and one negative one, I am more likely to go by what the positive reports say. Also by reading the examples given by someone who criticizes the doctor (specifics have to be given) one can always decide whether that particular aspect is relevant or important to us.  The doctors should have faith in us patients to make the right decision. Patients are not fools, they understand what is important. And if a doctor is troubled by negative remarks, he/she can always ask satisfied patients to write about him.

Related Reading: Can doctors be measured by another yardstick? (from other professions)
Shortage of docs leads to high workload and stress
How India is coping with the shortage of doctors

46 Comments leave one →
  1. September 3, 2009 10:34 am

    That’s interesting! I didn’t know ratemd.com ‘rated’ doctors in India too. Is this a recent development?

  2. September 3, 2009 10:45 am

    Excellent example of how Web 2.0 is changing our real lives.

  3. September 3, 2009 11:00 am

    True..but then aren’t we all comfortable with our family docs? And when we want to find a specialist, we always go through them, unless of course it is an emergency, where we rush to a hospital..

    And yes while, it can be useful, how many people use it is a question. If you take other services, say eateries , I can review say a couple of them a week, but that is not going to happen with doctors..

  4. September 3, 2009 11:09 am

    Rating the docs is a good idea.. especially in a country like ours where there are more ways to a medical college than hardwork and studies.. :-)

  5. September 3, 2009 11:41 am

    Frankly,I was not aware of the site where docs could be rated.Thanks for update.
    I wonder,if this is relevant in India.All the Govt employees get free treatment from various centres ,like CGHS Delhi for central Govt employees.All the forces officers and staff get life time free treatment.Less said about the politiciansis better.They get free VIP treatment where ever they are treated.Their foreign treatment is also financed by you and me.
    This leaves few like us,who most probably go to their family Dr.
    Rest of the people in India can hardly afford any medical treatment.
    However,I am sorry if I have sounded very negative.My personal experience is not very good.

  6. Vinod permalink
    September 3, 2009 1:31 pm

    The law in UK does hesitate to allow negligence suits against doctors to succeed. There is the ‘Bolam’ test now (google it). Perhaps it’s the same in India. The courts tend to defer to the opinion of medical schools of thoughts and experts in the field will rarely witness against each other. Even if they do, another expert can be brought to support the defendant doctor. Ultimately the court reserves discretion to hold the doctor liable regardless of expert evidence. I believe that the law has to take a closer look at the procedure being performed. If it is a specialized procedure then it should give a lot of leeway to the doctor. If it is a routine procedure then it should not. And where there is doubt about the specilization involved in the procedure, it should rule in favour of the doctor.

    • Vinod permalink
      September 3, 2009 1:39 pm

      Just google for ‘causation in medical malpractice’ or simply ‘medical malpractice’ and there are a number of articles explaining the difficulties in medical negligence cases. Some of these cases are really interesting actually. Thinking about them takes one to the field of philosophy – what is causation?

  7. September 3, 2009 1:59 pm

    mummyjaan, this site itself is not very old, I think it started in the last year or two. I am not sure when the India thing started.

    Mahendra, yeah isn’t it! It is replacing word of mouth and how!

    Vishesh, suppose your family doc doesn’t know a doc in the city you are moving to? We have had this experience twice, once in Kolkata and once in Bhopal. It is pretty terrifying to be in a new city with kids and without a reliable familiar doctor.

    oorja, yeah. Rich people pay up to 40 to 50 laks for a seat! Imagine how dumb their kid must be! Sorry to say that, but I am totally against donations to educational institutions. High fees are one thing, donations (which are common in pvt medical college where the more meritorious students pay less) another.

    BKC, I enjoyed reading your comment. :) Some gems there!

    Vinod, I agree, this subject of medical negligence is very interesting and very complex. Overall I agree too that the odds are in favour of the doctors as the medical fraternity protects its own. I didn’t know it was so in the UK as well.

  8. September 3, 2009 3:28 pm

    Interesting information especially for a doc Nita. Never knew about it. I will welcome patients rating me. In the amount of time waiting I may score poorly for the last 2 months because of the fever season. Bed side manners and communication skills are I think my strengths. I try to keep up dated and the internet is a great boon for that. The malpractise cases are now dealt by Consumer courts with quite a large number of judgements going against doctors. Thus even in India USA style defensive medicine practise is gaining popularity

    • Vinod permalink
      September 3, 2009 3:46 pm

      Charakan, could you elaborate on ‘defensive medical practices’? Thanks

      • September 3, 2009 5:05 pm

        Vinod , What I meant is each and every patient who walks in is considered as a potential litigant. All the decisions regarding the investigations and management of the patient are taken as if preparing for defending malpractise litigation leaving behind no loopholes. This makes the diagnosis and treatment time consuming and expensive.

    • Vinod permalink
      September 3, 2009 6:42 pm

      Thanks Charakan. Does it affect the procedures and operations that a doctor would be willing to do?

      • September 4, 2009 6:48 am

        Vinod, Defensive medicine certainly increases the number of tests done and the length of hospital stay but may not change the operative procedure involved. If someone comes with a headache and though you are pretty sure it is migraine in a defensive mode you may start treatment only after seeing the MRI Scan. Kickbacks that you may receive from scan centre may also be an incentive. In Europe where public money is involved there is lot of cost auditing and you may have to explain in detail why you ordered MRI.

  9. September 3, 2009 11:50 pm

    Its really a good thing and interesting also… it seems to be sitemakers has worked a lot in getting the info… and as you have said its important for us when we move to different cities

  10. Naveen permalink
    September 4, 2009 12:15 am

    In America, they often refer the Healthcare system as Healthcare Industry. Today the system is more about being an industry than about healthcare. My daughter fell off the growth chart for a few months. And the doctor started explaining me the benefits of growth hormone replacement. I knew where she was going as I started to count the GH drug label displayed all over her office -on the clock, calender, scribble pads, pens, paper weight, her apron… I told her that there were individual and ethnic differences in growth patterns and Indian children don’t grow as Caucasian and African kids. I challenged her that I’d show her scientific evidence until which she did not give in. One month and my daughter picked up her weight.

    Is it a coincidence that Pharma companies spend twice the money on Ads and gifts/treats to doctors than actually spend on R&D? When I asked a representative why they do that -his answer was ‘because it works’. By making social shyness a disease (Social Anxiety Disorder) by simply ‘disease mongering’, the pharma/doctors could sell billions of dollars worth prozac to otherwise healthy people. In America, teachers diagnose hyperactive kids with ADHD and the doctors drug them with powerful psychiatric drugs. And if a parent refuses the treatment, the state takes control of the child. Every school shooting in America is linked to a child on psychiatric drugs. To know more, read about the antipsychiatry movement.

    While greed is driving the healthcare system in the US, incompetence is at its core in India. A doctor tells his patient to break a tablet labelled -CR(Controlled release) and take one half in the morning and the other in the night. There is no ‘disease management’ what-so-ever. More than 95% of doctors work without any paperwork or taking patient’s disease history into account. Is it a wonder that patients in India with long history of diabetes are never tested for organ(s) functioning?

    • Vinod permalink
      September 4, 2009 7:21 am

      The standard psychiatry manual that is reffered to by psychiatrists to identify disorders has its own politics around it. Big Pharma have got their filthy hands on that too. The reviewers on the Board of American Assn for Psychiatry (or whatever its called) all have links to Big Pharma.

      • September 4, 2009 1:36 pm

        A small change in prescription habit of doctors means millions of dollar gain or loss for Pharma companies And some doctors are easily influenced by the Pharma incentives . What is the way out?

        • Naveen permalink
          September 4, 2009 7:35 pm

          Consumer education? Patients should ask their doctors the specific side effects of each drug. A printed copy of possible side effects is generally given with every drug purchase in the west.

  11. September 4, 2009 7:25 am

    Nita, there is a book called ‘The best doctors of Delhi’ which was published about 15 years back. I used the book a few times and wasn’t disappointed.

  12. September 4, 2009 10:53 am

    When you have 50% seats reserved for SC/ST/OBC in medical institutions, when meritocracy is already overtaken by reservation system, I dont think this rating system is going be used for any cause nor it will be useful ..

    I got around 90% in my 12th .. But could not find a seat in medical .. 50% went to reservation .. 5% went to women .. only 45% was left and I could not get my share as i wasn’t that inclined for medical nor I was capable of paying 35 lac as donation .. I did engineering and I think it was a blessing in disguise as I’m extremely happy about my job and career right now ..

    My friend got 91% but then he was so willing to become a doctor that he paid 35 lacs as donation to get into the medical college ..

    I do loathe donation system but we, as a general category students, have to pay donation not by choice but by complusion-by frustration .. Everyone wants a good career so by hook or by crook, they achieve it .. I feel that there should be an end to reservation system – may be max 20% is ok with me but 50% is way too much .. Plus there should be some minimum qualification required for donation system like minimin 70% one must have achieved ..

    I dont know where this will end .. I am somehow very scared to go to unknown doctors as I fear that is he/she a doctor by merit or by reservation ..

    • Vivek Khadpekar permalink
      September 4, 2009 11:09 pm

      Soham,

      //I got around 90% in my 12th .. But could not find a seat in medical……I could not get my share as i wasn’t that inclined for medical……My friend got 91% but then he was so willing to become a doctor that he paid 35 lacs as donation to get into the medical college//

      You “could not find” a seat in something that you admit not having an inclination for. Your friend got one per cent more than you “but he was so willing…” that…etc. You make it sound as if your friend, who was 1.1 per cent more meritorious than you was also not inclined to enrol for medicine, but he sacrificed his inclination in favour of a nobler cause, and also paid Rs. 35 lacs for the privilege of making this sacrifice.

      This is very confusing. Could you please explain?

      • September 7, 2009 9:44 am

        Yeah .. I wrote that comment in a hurry and I mdae it look awful ..

        The thing is, my mom-dad booth r doctors so they wanted me to become a doctor .. But as I could not get a seat even after scoring 90% coz of thsese reservation, they were ready to pay the donation .. But then I told them not ot waste money on that as I was getting an admission in one of the top engineering branch and I’m ok with both medical or engineering .. It’s just I dont feel that spending 35 lac just for MBBS degree is not worth .. So I opted for engineering ..

        My friend got 91% but he too did not get a seat in medical .. but he was totally inclined to become a doctor adn had no interest in engineering .. so he paid those 35 lac as donation and opted for medical ..

        So I said: I do loathe donation system but we, as a general category students, have to pay donation not by choice but by complusion-by frustration ..

        I hope it clears out the confusion !!

        • September 7, 2009 12:08 pm

          Soham, I agree with your decision not to pay donation. Frankly I am against the system and I feel that if everyone refuses to pay, the system will go. By the way, it is illegal as well. I know people who wanted to be something in a field but refused to pay the donation. I respect this choice because it is a matter of principle. However everyone has different ways of looking at it. I am just giving you my opinion. Everyone who wants something badly may not pay a donation. I know someone who skipped two years and tried again and again. Finally got through to a govt. medical. They were rich, could have afforded the donation.

        • Jane permalink
          September 10, 2009 9:42 pm

          I would rather get a doctor in my own culture. I have enough time understanding him/her.

  13. September 4, 2009 11:11 am

    I skip commenting, my views will be too bias! ;) :D

    • September 4, 2009 6:23 pm

      sakhi, biased views add spice to the discussion. :D

  14. September 4, 2009 6:09 pm

    I guess this would turn out to be like the ‘mouthshut’ site where most of the reviews are bad (as people rant only when the experience something bad) :).

    • September 4, 2009 6:22 pm

      xylene, surprisingly it isn’t so. Most reviews are good or average. I guess this is because the doctors are better than the products that mouthshut reviews! :) Thank God for that. :D

  15. September 4, 2009 6:21 pm

    There are places where doctors prescribe medicines after judging who you are, where you work and how much you can pay. I know few people in cities like Bangalore go to towns like Vellore (CMH) for treatment as the medical facilities are very costly and beyond the reach of a common man. There was a good medical insurance scheme for the poor going on in AP, where the poor people can get treatment in private hospitals and claim the expenses from the Government. I don’t know how it has done – I heard that even the TN Govt sent teams to study the model. If anyone from AP could share the details and how the scheme has done, it would be useful. Like finding a good school for the children, people should also put in efforts to find a good doctor. It helps.

    Destination Infinity

    • Naveen permalink
      September 4, 2009 7:11 pm

      DI, The medical insurance program in Andhra is called Rajiv Aarogyasri program. It covers 330 standard procedures in a select network of public/private healthcare providers. You can find more information at http://www.aarogyasri.org

      • September 8, 2009 4:52 pm

        Hey, thanks for the link. I learnt about the programme through an article in Hindu before a year, that’s why was curious.

        Destination Infinity

  16. wishtobeanon permalink
    September 4, 2009 7:10 pm

    My husband’s doctor(who was a good doctor actually) lost his license to practice after having had an affair/s with his patient/s; I used to go to him too, but didn’t feel very comfortable with him(though he was very friendly)…I then looked up his name on google and saw that some other woman had written a review on him and she thought something was wrong too. I quit and chose another doctor based on some internet reviews. The reviews are quite helpful especially when you move to a new city.

  17. September 5, 2009 12:28 am

    Nita, I came across an interesting study in the paper I just talked about in my blog. It discussed the study of health-care practitioners in Delhi, ones from the private sector and public health centres. The study measured their competence (as in their skill) and the amount of effort they put in for the patients.

    Interestingly, the practitioners at the Public Health centres had better capabilities than the private ones. But the private practitioners put in much more effort into treating their patients. This means that the public health providers were not motivated, most likely because they were paid fixed salaries and had no obvious means to exploit the system for personal gain, as people in India typically do.

    One interesting thing to note is that India seems to be logging the highest death rate among the highly affected countries in the current swine flu pandemic, which points to the general low competence of healthcare providers in India.

    • September 5, 2009 12:48 am

      Vikram, I humbly disagree with your view that the Novel H1N1 pandemic is causing so much deaths in India because of low competence of health care providers. My view is it is because the health care infrastructre in India especially in the Govt sector is one of the worst in the World. Indian Govt spends so little for health and most of it is eaten away by corruption.
      Indian health care providers are respected all over the World for their competence.

    • Vivek Khadpekar permalink
      September 5, 2009 7:07 am

      Vikram,

      I would be interested in reading that study you mention. My own experience (which would certainly not count as being statistically significant), also in Delhi several years ago, confirms the relative assessment you cite between private practitioners and those in public facilities. However, I find it difficult to agree that “This means that the public health providers were not motivated, most likely because they were paid fixed salaries and had no obvious means to exploit the system for personal gain”.

      Public health providers have to attend to far more patients in far more adverse working conditions. You may or may not agree with me, but there are several people in every field for whom monetary reward is not the prime determinant of how well they do their work. Any true and committed professional sets his or her own standards and does not compromise on them based on pecuniary reward.

      • September 5, 2009 8:49 am

        Vivek, this is the paper that has the details of the study,
        http://web.hks.harvard.edu/publications/getFile.aspx?Id=341

        starts on page 20.

      • September 5, 2009 11:05 am

        I agree with Vikram when he says there is lack of motivation among Govt health care providers. But as Vivek said lack of motivation is not purely financial. In Govt hospital where I worked for 7 years the more you work the more you get work.If in a crowded OPD you do work sincerely taking time to talk to and examine the patient the Q before you will never end. As the quantity of work increases quality decreases. You wont be paid for the extra work and also the professional standard gets lowered due to the huge number of patients . That is why I left Govt service.

        • September 5, 2009 10:15 pm

          Charakan and Vivek, yes there are definitely individuals who are dedicate and who go way beyond the call of duty. But in India, the norm seems to be exploitation.

          • Vivek Khadpekar permalink
            September 5, 2009 11:42 pm

            Vikram,

            Maybe I have been exceptionally fortunate. After becoming financially independent, I have lived in two major cities — Pune and Ahmedabad — for a combined total of over 30 years. In both these places, my experience with generalists as well as specialists has been by and large good. Some of them may charge relatively high (though not by metro standards) first-time consultation fees, but their professional services and commitment to the patient are generally impeccable. And unless they genuinely feel it is necessary, they don’t prescribe excessive lab tests or medication.

  18. September 6, 2009 11:02 am

    informative post!

  19. September 6, 2009 2:01 pm

    I think it is ridiculous to expect a non-medical patient to evaluate a doctor’s *knowledge*

  20. vasudev permalink
    September 7, 2009 2:45 pm

    i landed badly on my leg last wednesday while trying to do a spin and hit of the shuttle-cock. swollen and bruised, i landed at an ortho’s and through pain and haze came to understand all the perils they face in their profession when i heard him telling a nurse to do cbc/esr/ultrasono/xray/kft/lft…well, not on me but on another enrolled in-patient. some of these medicines do have side effects and perhaps the chap did not want to take any chance with whomsoever the patient was. i do not think he stopped with those but i got out in time.

  21. October 21, 2009 11:28 am

    I am visiting your blog, Nita, after ages! For that matter, I have not visited even my own till yesterday or so. Such is life.
    I read this post with a lot of interest. Some of the comments are right on the money. I checked the site you linked to and did not find the names of many/most doctors in India who are worth rating. So this site has a severe sampling error! :-)
    PS- As you can guess, I am not there….

    • October 22, 2009 5:19 pm

      Hi there. Long time no see! Looks like all my ole blogging friends are on a prolonged hiatus! And I think if your name is not on the site, good for you! :) I mean, one tends to write stuff when one is digruntled for sure! This means that you don’t have any angry patients! :D

  22. June 2, 2010 11:21 am

    Very well written and absolutely spot on.

    India could benefit from all kinds of reputation based sites on the web. The problem is none of them take off. India doesn’t have a very large number of web users who create content yet. It will (hopefully) come, but India (and only wealthy India at that) is just entering the “consuming” content phases of internet adoption.

    The net result is that the majority of these rating sites are filled with low quality content, advertising, self promotion and other things which ruin the movement. Mouthshut.com did a good job here by promoting the hell out of itself on the back of auto-rickshaws, perhaps if Doctors / Hospitals got on board and encourages patients to rate them we’d see a trend.

  23. vasudev permalink
    October 9, 2010 10:06 pm

    if you suffer from hernia try this doctor: narendra mehta. he practices at lilavati.

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