House Calls / Dr. Michael Schwartz

Physician "rating" sites supposedly offer patients a means to explore information on health care professionals. Several companies claim to offer prospective patients the ability to compare providers based on education, experience and board certification. However, many of these websites are fraught with serious flaws.

Some studies suggest that two-thirds of the population uses the Internet to seek medical information, including choosing their physician. Too often, however, the information posted on many physician "rating" sites is incorrect, frequently listing prior office locations, incorrect contact information and inaccurate hospital affiliations.

Deceased physicians and physicians who have lost their licenses are often included in the rankings on many sites. On a personal note, my office address and medical school education has been listed incorrectly on more than one rating website.

Many of these sites rank physicians using criteria including medical school attended, residency training and whether the physician is active in teaching or medical research.

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Although there has never been definitive proof that medical school training translates into physician competence or ability, many sites give higher rankings for well known or prestigious programs.

Finally, the most critical and controversial aspect of the physician ratings is patient input.

Patient ratings are extremely subjective and are often based on the relationship with their physician rather than the actual care they receive and thus not always credible.

A physician who has a pleasant demeanor or spends a significantly longer time with a patient may receive a higher rating although they are not necessarily more competent in proper diagnosis or treatment. In addition, there are too many variables involved in each patient visit to truly and accurately reflect quality of care.

For example, if a patient requested an antibiotic during a routine sick visit and the physician denied their request because the patient was diagnosed with a virus not requiring an antibiotic, they may place a negative feedback for their physician.

Eileen Smith, executive director of Soundview Medical Associates in Norwalk stated, "Often, only disgruntled patients take the time to post on these types of sites. There is little or no monitoring for validity. In addition, the companies housing the websites don't or won't trace the IP address, so if there is a vicious or untrue posting it is very difficult to have it removed or know who posted to try and resolve. Some sites will however ensure that the person posting a comment is a patient of the doctor, and that they include an email address."

Furthermore, sometimes patients may leave responses under the wrong doctor due to mixing up doctors with the same name. On the flip side, there in nothing to prevent the physician, family members or friends from leaving positive results on a physician rating site.

Physicians who receive poor reviews often have no recourse to dispute the negative feedback.

This can adversely affect their practice ultimately costing them significant lost revenue. In addition, the limited amount of reviews received by physicians also makes it difficult to get an accurate reflection on the physician's office and care.

Ms. Smith also suggests that patients looking for useful information can contact their local medical society for similar information.

"Health insurers are more than happy to help the patient find doctors by specialty or location," she said. "One site, Zoc Doc, offers on line appointments if the doctor's office participates with the software. It is linked into the doctor's appointments. Coming soon will be the ability to just `book' an appointment using a handheld device. Costs are only to the doctors, there is no cost to the patient."

Earlier this year, the U.S. government's Medicare site announced it will begin physician "rating." It even claims "The purpose of Physician Compare is to help you make informed choices about the health care you receive through Medicare."

Unfortunately, even this site has many errors in reporting. For example, my office address is incorrect and the site claims I speak Chinese and French -- I speak neither language.

Much of the criticism of these sites stems from the lack of transparency and perceived oversight of many of the online rating companies.

Another disturbing aspect is that many of these companies are for-profit, and therefore have additional agendas while promoting a rating system.

The Internet is an excellent tool that allows consumers to research and explore many details before making decisions about what items they want to purchase, where they want to vacation and now evidently who they will choose to care for their health care.

However, choosing a physician can be difficult and consumers need to shop carefully.

Bias and subjective information can be misleading. Recognize the limitations.

Most health care organizations still recommend that you ask your friends and family who they use as their physician and if they are happy with their care.

Word of mouth is still the best way to choose a competent and compassionate physician. Patients can also help their physicians.

If you have had a positive experience, take the time to leave a positive review.

Dr. Michael Schwartz is board certified in internal medicine with a private practice in Darien. Contact Dr. Schwartz at