Doctors Reviewed Online

One of the growing trends online that has been spreading like a virus is that of sites that allow people to provide feedback on goods or services they have received. The ability to have an independent platform for both praise and complaints is refreshing to many. After all, most people trust "word of mouth," and the relation of personal experience far more than any sales pitch. It is the trend du jour, as sites across the net will demonstrate. There are websites for rating and reviewing all kinds of products and services ranging from cars to college professors, and now there are a whole new generation that focus on health care providers.

Via Shari Roan of The Atlanta Journal-Constitution:

They're saying what they think about the state of health care and, more specifically, the doctors who provide it. Dozens of Web sites that permit people to rate, review, spin or flame their doctors have sprung up in the past year, operating in much the same way as online services that help people find hotels or plumbers.

Patients and site operators say the trend is good for consumers and good for health care. Thoughtful doctors, they say, will provide better customer service because of the feedback, and the bad ones will no longer be able to hide. Many physicians say the reviews on RateMDs.com, Vitals.com, DrScore.com and other sites are skewed by disgruntled patients and are unfair, pushing some doctors to near-ruin after a single post.

Ms. Roan provides a lot of solid background and quotes from authorities that are both pro and con. She also includes a bullet list of the six top sites for the rating and reviewing of health care professionals.

Since legally a doctor cannot publicly discuss a patient's health care, they are at a bit of a disadvantage as far as dealing with detractors on the Internet, to say the least. It remains to be seen how much impact reviews like these will have on bad doctors, and likewise how much damage might be done to the good ones. In the past, I have worked in the service and retail industries, and in both it was very much a truism that 99% of people will never comment unless they have a complaint. This tendency has potential to skew these sites, so it will be interesting to watch the evolution of checks and balances develop as they evolve.

SOURCE: "Doctors are 'in' for online evaluation" 07/30/08
photo courtesy of Geishaboy500 used under its Creative Commons license

Health Care Access: Steadily Deteriorating Since 2003!

AMedNews calls itself "The Newspaper for America's Physicians." A trade publication for Health Care Providers, they tend to cover topics pertinent to this blog. Hardly shocking.

This time they bring us a bit of news that is shocking, or at least highly disturbing, especially in light of many topics we have covered here in the past. The article's subtitle is an excellent summation: "One report finds that millions more insured patients are delaying or not getting care, while another shows a spike in 'underinsured' Americans."

Doug Trapp brings us the findings and analysis:

One in five Americans -- 59 million people -- reported delaying or not getting needed health care in 2007, up from one in seven in 2003, found a June 26 Center for Studying Health System Change report. "We've been tracking access to care for 10 years, and this is by far the biggest change that we've seen in those 10 years," said Peter Cunningham, PhD, study co-author and senior fellow at the center. Of those reporting an access problem last year, 43.5 million had insurance, compared with 25.9 million in 2003.

In a similar vein, the number of underinsured -- steadily insured people who paid significant out-of-pocket costs for health care -- reached 25.2 million people in 2007, up from 15.6 million in 2003, according to an analysis by the Commonwealth Fund published online June 10 in the journal Health Affairs.

As always when examining the state of the current system, the hard numbers are disheartening. According to Mr. Trapp's reporting, a significant number of those uninsured are among those who earned 200% of the federally determined poverty level.

Access is an issue, now more than ever:

The center's report found growing access problems for children. Among all children, 3.9% had an unmet health care need in 2007, up from 2.2% in 2003 and 3.2% in 1996-97. Cunningham said children's access likely is being affected by the higher insurance costs their parents are facing.

Some people with access problems had trouble making or getting to medical appointments, the center reported. Fifty-eight percent of adults with access problems said the health system was a reason. Of those, 28.6% said they could not get to a doctor's office or clinic when it was open.

"This report is really a warning about seismic change in our health care system," said David Colby, PhD, vice president for research and evaluation at the Robert Wood Johnson Foundation, which funded the center's study. "With each passing year, more Americans are really falling behind when it comes to getting the medical care they need."

The reports he refers to show that cost of care, that consistent bugaboo, once again rears its ugly head as the culprit. Larger deductibles, tighter spending limits, and other factors being introduced on the insurance end of the equation are creating a prohibitive environment for health care access. This is something pointed towards by prior studies, but now is documented.
In addition, the Commonwealth Fund report noted a 62% jump in uninsured adults during the 2003-2007 period studied. I cannot help but wonder if those individuals are included in the oft-quoted number of 47 million uninsured Americans.

The article contains a wealth of information and documentation including a supplement at the end which presents the statistical data as a series of graphs and additional links to source data and online discussions.
SOURCE: "Health care access problems surge among insured Americans" 07/21/08
photo courtesy of FuzzCaminske, used under its Creative Commons license