Everything Changes - The Guide to Young Adult Cancer

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?