Wednesday, September 01, 2010

評價網站: 網上評分醫療專業人員 / Rating Sites: On-line Rating of Physicians, Medical Doctors MDs

Is there a doctor in the (dog) house?

I have heard this cliché often enough in movies and on TV. When someone yells "Is there a doctor in the house?", I understand right-a-way there is an emergency situation that requires medical attention. Whether the doctor who is willing to volunteer (some will not identify themselves for fear of potential liabilities and law suits) is a good one or not seems immaterial. But what if I am the patient and I actually have a choice. Will I just accept any doctor listed in the phone book, or referred to me by others? How do I know whether a doctor has been sued for malpractice?

Fear not !!! I just recently discovered that there are actually websites where patients can evaluate and make comments abt their physicians/medical doctors MDs. Now, I don't usually believe in on-line consumer reports because information can be manipulated by friends and supporters of a given product or service. However, when I searched the names of two doctors that I have dealings with, I had to say the comments posted were not that far off from my own personal view. The "good" doctor always takes time to explain things and treats ppl with care and respect, while the "bad" doc is impatient and even tells patients to stop complaining abt her painful poking and jabbing. Now, whenever I hear the phrase "Is there a doctor in the house?", my immediate reaction would be "Just not those in the dog house".

So, here is a question: Are ratings sites flourishing behind a veil of anonymity ?!! / 評分網站蓬勃發展 - 但躲在背後是不是一個不願透露姓名的面紗?!!

Please feel free to comment on the pros/cons of rating sites. Do you think the info are reliable / misleading?


Here is a report from CTV, Canada: News Staff / Jan. 13 2007 9:45 PM ET

Whether your physician is the hurried type with his hand on the doorknob, has the bedside manner of a tornado, or has the patience of a saint, you can now anonymously rate your doctor on a controversial new site.

Founders of say their website is designed to help patients better navigate the world of health care. But the free site is being denounced by critics who say the anonymous postings are potentially defamatory, and don't provide enough protection from disgruntled patients who use them to post malicious clients.

There are more than 47,500 doctors listed on the site, of which nearly 7,000 were Canadian. The California-based website is now getting some 300 Canadian patients registered each day.

The doctors are rated on punctuality, friendliness and helpfulness. Depending on a doctor's score, the website will assign a yellow happy face, green neutral face or blue frown next to the doctor's name. Users can also post their feedback without leaving their name.

"I found the unnecessary callbacks to be nothing but an easy cash grab for the doctor. It is absolutely ridiculous to have to return monthly for a prescription that you have been on for years," one statement says.

Another statement complains that the doctor "continues to advertise that she is accepting new patients even though the waiting period is regularly one to two hours."

One posting on an obstetrician/gynecologist says, "I think he should have been a vet, strictly for horses."

Yet another note complained "Very unsympathetic to my concerns, when I switched to another MD after moving, I found his record taking was abysmal and some pertinent tests were not ordered."

The website's creator in California calls the site a much-needed shopping tool for patients that delivers a clear message to doctors. "It's a matter of life and death," co-founder John Swapceinski told CTV News. "This is the way media is moving, so get used to it."

The site was create in March 2004 after the success of another site Swapceinski founded, called The doctor rating site, which has expanded to include Canadian listings, has exploded in popularity here in the past month. The sites rely on volunteer administrators to delete ratings that may:

Defy online guidelines, such as prohibitions against obscenity
Include racially derogatory comments
Refer to pending legal action
Allege illegal behaviour
Identify the patient

But Dr. Michael Gordon, of the University of Toronto's Joint Centre for Bioethics, is no fan of the site because he says the information just isn't credible. He says the complaints are anonymous so an irate patient could potentially barrage the site with several angry comments.

"You don't know what's motivating them, there is no way because it's anonymous," he said.

Similarly, doctors could file repeated favourable ratings to falsely inflate their reputations. The Canadian Medical Protective Association, the Canadian organization that represents 71,000 doctors in medical malpractice matters, has already asked the site to remove potentially defamatory comments. The site's operators have so far removed at least two of the seven most scathing comments about doctors at the request of the CMPA. The organization has also asked for the names and addresses of users who have filed "clearly defamatory" statements, but site managers have refused. The CMPA has also requested:

That it be provided with the users' IP (Internet protocol address) so that it can then ask for a court order to determine if the information can be used to reveal their identities
That the site post a notice to Canadian users telling them that freedom of speech and libel laws differ in each country
That the site remove Canadian content identified as defamatory

Swapceinski has said he would not give out identifying information unless there is a threat of violence in a posted comment. He told CTV News that the site is created for patients who may be afraid to talk to their doctors and want the anonymity of the Internet to air their beefs.

"People have a right to express their opinion and not to have their free speech stifled by threats from medical associations," Swapceinski said.

But doctors say patients need to confront their physicians or even file a complaint with their local College of Physicians and Surgeons should they have concerns. Sites that encourage anonymous ratings raise thorny questions about the boundaries of Internet law, observers say.

CTV's legal analyst Steven Skurka says that a defence of innocent dissemination that can be used under Canadian libel law.

"That would provide a full defence to a host website provider to any issue raised about the content posted on the website," he told "As long as the host has no control over the comment that is posted, they'll be able to rely on that defence."

If however, there is an element of control -- which is open to interpretation -- the website provider may face accusations of libel, Skurka said.

With a report from CTV's Avis Favaro and Elizabeth St. Philip


More related articles/info:
* The website mentioned in the CTV transcript
* National Review of Medicine
* New York Times
* Boston Globe
* Wikipedia: Rating Site

Photo Credit:
* Wikipedia Physician / Medical doctor

Disclaimer / Caution: This article reflects only my personal experience and does not constitute endorsement of any on-line websites. The posting and use of such on-line rating information are controversial. For matters concerning health and well-beings, readers must consult and seek advice from certified medical professionals.

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