Healthcare Economist: (NY Times) Why are there no doctor reviews on the web?

Why are there no doctor reviews on the web?:

The N.Y. Times has an interesting article citing a number of reasons why there are no good websites with doctors reviews on the web.  There are some ratings websites (HealthGrades, RateMDs, Angie’s List, Yelp), but the listings are often sparse, with few contributors and little of substance.)
For one, physicians don’t like them.
“Several years ago, a physician reputation management service called Medical Justice developed a sort of liability vaccine. Doctors would ask patients to sign an agreement promising not to post about the doctor online; in exchange, patients would get additional privacy protections.

blog: The Patient Will Rate You Now

The Patient Will Rate You Now:
By Bob Wachter, MD

These days, I’d never consider trying a new restaurant or hotel without reading the on-line ratings on TripAdvisor or Yelp. I seldom even bother with professional restaurant or travel critics.
Until recently, there was little patient-generated information about doctors, practices or hospitals to help inform patient decisions. But that is rapidly changing, and the results may be every bit as transformative as they have been in traditionally consumer-centric industries like hospitality. Medicine has never thought much of the wisdom of crowds, but the times, as the song goes, they are a-changin’.

Disruptive Women in Health Care » Blog Archive » What Does It Matter to You: Patient Activation and Good Health Outcomes (on attitudes, knowledge, communication and abuse??)

Disruptive Women in Health Care » Blog Archive » What Does It Matter to You: Patient Activation and Good Health Outcomes

pdf: Summaries for Patients - Surrogate Decision Makers’ Interpretation of Prognostic Information

Surrogate Decision Makers’ Interpretation of Prognostic Information

What are the implications of the study?

Inaccurate interpretations of doctors’ prognostications arise partly from optimistic biases rather than simply from misunderstandings. Helping surrogates attain realistic expectations about patients’ likely outcomes is more complex than just giving clear information.

Weighing the Chances at Life's End - NYTimes.com

Weighing the Chances at Life's End - NYTimes.com


"........But the grimmer the prognosis, the more inaccurate and more optimistic the surrogates’ responses became. Only 22 percent correctly interpreted a statement about what a “5 percent chance of surviving” meant, while 65 percent answered with greater optimism.
“They clearly grasped the meaning of these statements,” Dr. White said. “They were not misunderstanding the numbers. They weren’t misunderstanding the language.” If that had been the case, you’d expect them to have been inaccurate about good news, too.
Instead, relatives hearing doctors deliver dire prognoses just didn’t accept or believe them. They displayed, in medspeak, “a systematic optimism bias.”
Such bias has shown up many times before in the medical literature. Cancer patients enrolled in early phases of clinical trials, for instance,....."

the Commonwealth Fund (Harvard): Who Are We Reaching Through the Patient Portal: Engaging the Already Engaged?

http://tinyurl.com/6tqadrd

open access: The patient, the illness, the doctor, the decision: negotiating a ‘new way’ through person-centered medicine - International Journal of Person Centered Medicine

 "As we write, nowhere within modern medicine is the need for greater understanding more acutely necessary than in its philosophy of the patient as a person......


Full Text: PDF

"Call It Cancer" - Editorial - the Oncologist

Blogger's Note: comments/interpretation:

excerpt from article: "...A more controversial aspect of the NIH panel’s report wasthe statement that it may be a mistake to call low-grade low-volume prostate cancer a “cancer” in these patients...."

• the Oncologist is a subscriber-based publication; 

• the 'gist' of the article is a focus on prostate cancer, but the theme is transferable to all cancers - a discussion on what to call (prostate) cancers eg. those at low/high risk of recurrence, the same could be applied to ovarian cancer eg. LMP; the authors conclusions are just to call it cancer so as not to distract patients from understanding that risks including those still outstandsing and unknown issues (and of course those with rare subtypes of differing cancers, as an example)
• a good discussion for those who are getting 'off track' - psychosocial aspects and what is meaningful to patients/providers who deal with cancer in real life

abstract: Different perspectives on communication quality and emotional functioning during routine oncology consultations

Results

The patients’ ratings of communication quality differed significantly from those of both the physician and observer. Observer and physician scores did not differ significantly. Physicians rated emotional functioning as discussed more often than was reported from patient and observer perspectives.

Conclusion

The patients’ view of the quality of communication differed from that of the physician and observer. Whether emotional functioning was discussed or not was also perceived differently by patients, physicians, and observer.

The Nature and Timing of Family-Provider Communication in Late-Stage Cancer:abstract

abstract: What do we know about patients' perceptions of continuity of care? A meta-synthesis of qualitative studies

Abstract

Objective The increasing complexity in healthcare delivery might impede the achievement of continuity of care, being defined as ‘one patient experiencing care over time as coherent and linked’. This article aims to improve the knowledge on patients' perceptions of relational (RC), informational (IC) and management continuity (MC) across care levels.

Results The selected 25 studies most frequently investigated RC. Being attended to regularly and over time by one physician (RC) was valued by chronic ill patients, but balanced with convenient access by young patients (MC). Communication and information transfer across care settings as well as the gathering of holistic information about the patient were perceived to foster IC. Critical features for achieving MC were accessibility between care levels, individualized care and a smooth discharge process including the receipt of support. Patients further considered that their personal involvement was one facilitating element of continuity of care.

Vote: Should Physicians Use Email to Communicate With Patients? - Health Blog - WSJ + comments

Medscape: Most Parents Disclose Cancer Gene Results to Children

1) Medscape link

 January 10, 2012 — The majority of parents who are tested for BRCA1 and BRCA2 genes share those results with their children. In fact, a number of parents even discuss the results with very young children, according to a study published online January 9 in Cancer....

2) Cancer Journal

link to abstract:  When parents disclose BRCA1/2 test results: Their communication and perceptions of offspring response

Walking a tightrope: oncologists' perspective on providing information to women with recurrent ovarian cancer (ROC) during the medical encounter.

Are you giving your doctor a headache? - CNN.com

A thesis presented to the Department of Biological Sciences – Genetic CounselingCommunication of Lynch Syndrome Genetic Test Results: Strategies to Facilitate Information Sharing with At-risk Family Members

"...Results can then be used to develop new tools such as more
patient-friendly online resources similar to those offered by the hereditary breast and
ovarian cancer organization, FORCE......"

‘You’ve Got Mail’ — But Not From Your Doctor! Only 7% Are Emailing Patients - Health Blog - WSJ

A whisper-game perspective on the family communication of DNA-test results: a retrospective study on the communication process of BRCA1/2-test results

"...Unclassified-variants were most frequently misinterpreted by probands and relatives, and had the largest differences between probands' and relatives' perceptions...."

CMAJ: Medical errors increasing because of complexity of care and breakdown in doctor–patient relationship, physician consultant says

Patient-Computer Dialogue: A Hope for the Future — Mayo Clinic Proceedings (e-health/e-patients & physicians)