Archive for April, 2008

Angie’s List Now Rates Doctors

Posted: April 30, 2008 by Doc in Medical
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Online Ratings Irk Doctors
By Kim Painter,
see original article at USA TODAY
Considering a new doctor? Hoping to learn more about a doctor you already see? Or maybe you’d like to praise or pan one.

You could do it the old-fashioned way and talk to friends and relatives or even the doctor in question. Or you could do this: Go online and read and respond (anonymously, if you like) to everything you find about that doctor, not only on basic search engines but on a growing list of websites that rate, rank and dissect the careers of physicians.

As of this month, you can even read and write doctor ratings at Angie’s List, the site where members in 120 metropolitan areas rank their plumbers, roofers and landscapers.

But before you start clicking, know this: Your doctor may hate being treated like a plumber — or a dating show contestant.

“Imagine there was a dating site where every time you went on a date, someone could rate you,” says Delia Chiaramonte, a family physician and patient adviser in Towson, Md. “That would really change the way you saw dating. … It definitely makes (doctors) paranoid.”

Doctor-rating sites — especially those that include patient ratings and comments — have the potential to sour already strained relationships between the nation’s patients and physicians, Chiaramonte and other critics say. Though doctors care very much what patients think and welcome scientifically valid patient surveys, anonymous online ratings and rants can ruin reputations and destroy trust, says Nancy Nielsen, president-elect of the American Medical Association.

Patient care suffers, the critics say, when doctors are made defensive and fearful.

But the creators of such sites say they offer essential information. Some, including HealthGrades.com and the newer Vitals.com, include details on training, experience, certification and disciplinary history along with patient ratings. Some include information supplied by physicians: At HealthGrades.com, physicians can pay a fee to add details and even a video to their profiles, says spokesman Scott Shapiro; at Angie’s List, physicians are welcome to respond to members’ posts, says founder Angie Hicks. Vitals.com also invites physicians to respond, says co-founder Mitchell Rothschild.

Consumers are smart enough to consider the thoughts of other consumers as just one factor when choosing a physician, just as they have traditionally considered the opinions of friends and neighbors, Shapiro says. At HealthGrades.com, consumer ratings (on factors ranging from office cleanliness to a physician’s listening skills) are just “one data element among many,” he says. The site does not include free-form comments.

Angie’s List does, and the comments are useful, Hicks says: “People are still looking for that over-the-back-fence kind of recommendation.”

But the fact that Web surfers can’t see who’s behind that fence bothers many physicians. “One disgruntled patient” could cause a lot of trouble, Nielsen says. And, she says, “doctors are not going to want to spend their time going into a (site) and correcting a smear.”

Hicks, Shapiro and Rothschild say their sites block multiple negative or positive postings from the same source. And, they say, the bottom line is that we live in an age in which consumers seek information from many different sources before making major decisions. The sites just make relevant facts and opinions more accessible, they say.

“A lot of information is good,” Rothschild says. “More is better.”

HOW TO TAKE THE MORE TRADITIONAL ROUTES

Here are some other options for checking out doctors:

    Ask for referrals from a physician you trust. Be sure to ask why your doctor recommends particular colleagues.
    Read doctor profiles at websites maintained by hospitals and physicians’ offices.
    Check with state medical boards for records of disciplinary action against a physician. Get started with the Federation of State Medical Boards at fsmb.org.

LINK:
How to Find a Doctor Online at CNN.com

ABEM “GRANDFATHERED” PHYSICIANS NOT CONSIDERED BOARD CERTIFED IN NEW YORK

For years, ABMS/ABEM/ACEP/AAEM have sought to eliminate competition from ABPS board certified physicians. In New York State, they seem to have tricked the DOH (Department of Health) into accepting their version of the facts: that only residency trained ER physicians are qualified to practice emergency medicine. Unfortunately, by so doing they may have also stripped board certification in Emergency Medicine from their grandfathered members, who are NOT residency trained in ER medicine.

In their rush to exclude competition from ABPS certified physicians from the practice of Emergency Medicine, ABMS/ABEM/ACEP/AAEM should have heeded the advice in the Proverbs of Solomon, regarding wisdom, or the common prudence, that everything cuts two ways!

ABMS/ABEM/ACEP/AAEM lobbied NYS- DOH to list only ABEM residency trained physicians on their website as being board certified in Emergency Medicine [http://nydoctorprofile.com].
ABPS sought the same privilege but were repeatedly, irrationally and arbitrarily denied. After being unfairly denied on multiple occasions, ABPS finally brought suit against the NYSDOH under Equal Protection, seeking to have ABPS certified physicians listed on the NYSDOH website as board certified, as other boards have successfully done in other states. (see ABCS case)

This issue has been contentiously argued. ACEP officials such as Dr. Melissa Graber
and Dr. Carol Rogala have vehemently castigated ABPS for filing this suit, asserting their lack of basis and ABPS’s reluctance to share their world view, that the only way to practice emergency medicine is after a residency in that specialty.

In other words, why can’t ABPS just keep quiet and allow ABMS/ABEM/ACEP/AAEM to continue their monopoly of Emergency Medicine?

Didn’t Daniels [Daniels v. ABEM] lose his case asserting monopolistic practice in Emergency Medicine by ABMS/ABEM/ACEP/AAEM? Not exactly. Daniels lost, but not on the merits.
Daniels was not dismissed on the merits. The error in the Daniels case was, when asked what he was seeking he said he wanted to practice emergency medicine, and if ABEM let him take their test then he would be able to practice. Simple enough, right? Daniels knew that ABMS/ABEM/ACEP/AAEM were lobbying so that for him to practice ER medicine, he had to join their group. He knew, that ABPS would face constant attack, notwithstanding the equivalency of their examination and certification process. That’s just the way it was and is.

But how could Daniels sue ABEM because ABEM won’t let him join them?

If what Daniels said was true and ABMS/ABEM were unlawful monopolizers, then a monopoly existed and he was being economically excluded. The court said, you can’t come to us to help you join a group you claim are unlawful monopolizers under the Sherman antitrust act. We the court, can’t help you join the monopolizers. Dismissed.

But what has occurred in NY is not much different.

Daniels should have joined ABPS and obtained their certification. His practice would have been impeded as well, since hospitals do not consider ABPS board certification and New York State won’t list ABPS as a legitimate board, because, ABMS/ABEM/ACEP/AAEM have lobbied to get NY State to help them eliminate their competitors.

New York listened and will not list a physician not residency trained in ER medicine as board certified on its website. This is inconsistent, since NY lists all the grandfathered ABEM certified physicians who definitely did not do residencies in ER medicine, as board certified.
ABPS cried “Foul!”

Of course, what’s interesting is that if the training was so unique, then any physician not trained in EM, would fail tests of the subject matter. But we know that’s not so…since ABEM grandfathered physicians have managed to do just that, and Daniels and many other excluded physicians are certainly no different in training from the physicians permitted grandfather status from an arbitrary closure of the practice track in EM.

In fact, all of the certified ABPS physicians are convinced they would also pass the ABEM board examination, just like their grand-fathered colleagues. Dwight Collman [ABEM certified], arguably the best ER Board Preparer in the country, did not do a residency in ER medicine. No one doubts his fund of knowledge nor his likely skill in the actual practice of EM.

And of course, what’s so wrong about using NY State to burden ABPS under the guise of jurisprudence or concern for the patient even if the relationship between the means and the ends are irrational? The fact that NY State ends up protecting ABEM/ABMS/ACEP/AAEM from economic competitors, though not a legitimate government purpose, well, that’s alright too, ABMS/ABEM/ACEP/AAEM knows best! Since the legal standard of review would be “rational basis” it seems that ABMS/ABEM/ACEP/AAEM took their chances. Anything can be deemed rational and many courts have found rationality when there was none.

The deck stacked in their favor, ABMS/ABEM/ACEP/AAEM pressed on in lockstep, with their self righteous, strong arm tactics, oblivious to cogent arguments against their positions from the State, who quite frankly, never investigated. What ABMS/ABEM/ACEP/AAEM/NYSDOH forget is that “rational basis” also cuts two ways and ab initio, does not mean abdication of judicial review.

If, as it is said, “Nothing cleanses like daylight”, then ABPS’s contention that its
certified member physicians are under unfair attack by unlawful discrimination, and that ABMS/ABEM/ACEP/AAEM have enlisted the State as aider and abettor in their attempt to destroy ABPS appears to be true.

Under the current NYSDOH rules, only ER residency trained and ABEM certified physicians can list themselves as board certified on the NY Physician Profile website.
(http://nydoctorprofile.com). The website defines “board certification” as:
“If a doctor is Board Certified, this means that he or she had graduated from medical school; completed residency (training in a hospital); trained under supervision in a specialty, and passed an exam given by a medical specialty board.”

That’s right. Under this rule, ABMS/ACEP/ABEM/AAEM, seeking to eliminate ABPS competition, also strips board certification in New York from ABEM grandfathered physicians, not residency trained in Emergency Medicine

Technically, those grandfathered physicians cannot promote themselves in NY State as “Board certified” because they did not do an EM residency. Also, on applications to hospitals that ask for Board Certified physicians, they are as precluded as are ABPS physicians from getting those jobs, although we all know they are just as qualified.

Should the NYSDOH de-list ABEM certified non ER residency trained as not being board certified? ABPS does not think so. To their credit, ABPS does not seek to disenfranchise ABEM grandfathered physicians, but regards them highly, and would be happy to provide them with a new home in AAPS [American Association of Physician Specialists]. All they seek is for their own certified physicians to be treated fairly.

links:
Fighting to “Level the Playing Field” for ABPS Docs in NY

Hear! Hear! Judge Decides NY AAPS Case Goes Forward

Disposable Doctors 2: ER Docs Fight Back in NY