Want to find the best vegan burger shack in town or a late night sushi-karaoke bar? Turn to Zagat. Want to find a good doctor? Now you can turn to Zagat too. WellPoint, one of the country’s largest health benefits companies, is contracting Zagat to create a patient review system of doctors. How egalitarian, how patient powered, how much more can you miss the mark?
Italian Vogue?
This new Zagat system of voting and popularity contests will lead young adult cancer patients (and others) towards making less educated and poorer choices about their doctors. Here are a few reasons why:
1. What if 42 patients give their oncologist a high score because they love the Italian Vogue mags in the waiting room and the friendly smile of their oncologist but don’t know that this doc has four violations pending against her with the state medical board? Zagat is not the answer.
2. What if six patients give their oncologist a low rating because the wait is long and the staff is rude, but they don’t know that this oncologist just flew to MD Anderson last week as the foremost expert in the world on your specific disease type and stage, and presented a paper on a new molecular treatment that has fewer side effects and avoids the need for surgery? Zagat is not the answer.
3. What if a patient on Zagat has extensively researched an oncologist, stating he is the most highly educated in the city in lymphoma care, but the patient is basing this information only on the fact that the doctor graduated from Harvard? Harvard alone does not a good doctor make. Has this doctor published research? Is he or she an active member of the international oncology community? How do they continue to educate themselves? Zagat is not the answer.
Taking Candy from Strangers
If you’re visiting Chicago for the first time and trust a stranger on the street to give you a recommendation for the best pizza in town, the stakes are not so high if their recommendation sucks. But we are talking about cancer, not pizza. You should not take the advice of strangers but rather turn to the most educated, medically astute friends, colleagues, and doctors you know to become your advisors – not a group of joe schmoes on-line. (I talk more extensively about this in the Working The System section of my book Everything Changes.)
I’m not alone in this thinking. Most of the medical ethicists and docs interviewed on the subject in the New York Times agree.
How you do decide what doctors to use? Do you think the Zagat guide is a good idea? Would you use it?
“Everything Changes is, without doubt, the most forthright, emotionally sophisticated, and plain-old valuable book of its kind I've seen.”
February 16th, 2009 at 9:21 PM
interesting. popularity does not equal competence.
February 18th, 2009 at 7:14 PM
Here is a blog of a MD who holds the opposite opinion: http://open.salon.com/content.php?cid=114257
I think it could be helpful if people use it as one of many sources of information, just for how doctors treat their patients like she proposes, but in reality it will probably be used as the only source of information because patients are really not educated enough about what to look for in a doctor.
I also prefer personable doctors that allow me to ask questions and answer me without getting annoyed because I like to know everything about my treatment possible. Even if a doctor is good I tend to get a bad feeling about them if they rush me or act like I am stupid.
February 18th, 2009 at 10:02 PM
Lisa,
Thanks for your post. While I don’t agree with her main argument, I found the MD who you linked to incredibly compassionate. Good to know that nice doctors exist!
Best,
Kairol
April 19th, 2009 at 3:51 PM
It’s not perfect, but I use US News and World report. Otherwise, I ask other patients. That’s how I ended up at Washington Hospital Center in DC.
Now that I live in NC, I go to Duke.
It’s very difficult to choose doctors when they have a bad bedside manner. But sometimes they are the best.
Actually, I’ve found that most patients will still recommend these doctors and tell you that you just have to put up with their personalities - and that it’s worth it for the care.
April 19th, 2009 at 10:51 PM
Nathania,
In my book, I write about what you just described: the multi-pronged approach. When you are using one of the popularity based guides - whether it is zagat or US News or a local Top Doc magazine article, it works best if you combine it with other references from patients, practitioners in the field, and from your own hunting online. You and I certainly share the same ethic around surviving a rotten bedside manner in order to get great medical wisdom and care.