Angie's List Offers Patients Place to Praise or Blame Physicians

By Kristina Fiore
INDIANAPOLIS, April 4 -- Angie's list, an online repository of customer-service ratings for plumbers, electricians, home contractors, and the like, sees physicians in the same light -- whether they like it or not.
Angie's list pays no heed to the age-old debate over whether physicians are service providers or professionals, whether those flocking to their offices are consumers, patrons or patients.
It simply invites those who see a doctor to post their views on whether the waiting room reading material was up to date, whether they were kept waiting too long, or whether the staffers were friendly and efficient -- those sorts of yardsticks. Same for a hospital visit or a trip to the drug store to pick up a prescription.
For $7 a month, consumers can log-in and grade physicians, hospitals, pharmacists, health insurers, and others. They can submit reports on anyone from their primary care physician to the entire staff of a hospital. Angle's list has 600,000 users nationally.
Grades A through F may be chosen for different aspects of service. These categories do not evaluate the doctor's professional skills so much as the quality of the overall experience. There are, however, questions on whether physicians offer cogent explanations of medical matters and whether they followed up if promised.
Nancy H. Nielsen, M.D., a Buffalo, N.Y., internist and president-elect of the AMA, wondered about the inherent fairness of the process.
"Patient satisfaction is important to physicians, and patients should have access to credible information so they can be confident in their choice of physician, but anonymous public web forums have many shortcomings," said Dr. Nielsen
"There is no guarantee that the opinions about a physician even come from that physician's patient. People may express dissatisfaction on these forums because they wanted a medication that wasn't medically necessary, or because they didn't receive a prescription or service that was delayed or denied by their insurance company."
Angie's list founder Angie Hicks, however, said what differentiates her service is the "integrity of the data" that is maintained by a number of checks to ensure credibility of all reports posted on the site.
A staff of reviewers looks at each report, making sure to note trends that question the validity of submissions. There's also a cap on the number of times a user can report on a physician.
And there is technically no anonymous reporting, Hicks said. "While other members can not see who posted the comments, the doctors and healthcare providers will be able to, so no, the reports are not anonymous," she said.
Physicians can register at no cost to have a summarized report on their ratings e-mailed to them, Hicks said. They are also encouraged to respond to the reports on-site.
Although there's no way a doctor can change a poor grade that's posted on the site, Hicks said reviews tend to be positive.
"The overall grade is an average of all reports doctors have received, so if they are giving great customer service and get one negative report it'll likely be a wash in the end," she said.
She also said that any negative feedback could be "a great way for doctors to improve the quality of service they're providing. Doctors, as will all the companies on the list, have the opportunity to see specific areas of service that could use some work."
"All physicians want to improve," agreed James King, M.D., a family physician in Selmer, Tenn., and president of the American Academy of Family Physicians (AAFP). "If we can get an honest review, we'd be happy to improve our practice. We just want to make sure that the data are accurate."
Accuracy of data has been a major concern for other doctor-ratings sites like RateMDs.com, Vitals.com, HealthGrades.com, DrScore.com.
Although about 70% of reviews on RateMDs.com are positive, John Swapceinski, founder of the site, says he's encountered a fair share of angry doctors.
"We get threats of legal action pretty much on a weekly basis," Swapceinski said, typically in the form of letters from lawyers demanding their clients' reviews be removed from the site. But cyber-law, he said, mandates that the web site operator is not liable for comments posted by users. So physician wanting to challenge a report would have to take it up with the individual poster.
The AAFP's Dr. King said that most physicians recognize that today's consumers are more savvy about knowing what information they can trust, and what information should be taken with skepticism.
"Patients need to realize that these kinds of lists grade us on qualities like how friendly the office environment is, whether there was a long wait in the waiting room," Dr. King said. "It doesn't grade our practice. As long as the patient understands that, it's fine."