Physician Online Reviews

My friend and practice advisor showed me two very negative anonymous reviews of my practice this week. Both were posted within a one-month winter period and were written about family members. They were not written by patients.

My staff and I tried diligently to identify the stated situations as they did not resonate with any of us.  Unfortunately, we were unsuccessful.  That frustrates each of us.

Combined, these reviews were aggressive and unflattering.  They mentioned my age, ego and seemingly lack of compassion.  I’d be lying if I said I wasn’t bothered by them.  I truly wish I could talk to those anonymous authors to learn their point of view and find out why they are so angry. I’d sincerely apologize to them if I did anything to cross a line.

At the end of the day, I like to look myself in the mirror and know that I have done the best I can for each of my patients. I am very passionate about my profession, care immensely about the well-being of each patient and believe in evidence-based medicine – not fads and or snake oil. I also hold true to my practice’s slogan – Access, Advocacy, Compassion and Prevention.

I spend a great deal of time in face to face meetings with my patients. I return all phone calls, call regarding all test and lab results and; usually I am aware when a patient is unhappy or dissatisfied.  If I am not aware, my office supervisor or staff know it and bring it to my attention so I can discuss the reason and clear the air or rectify the problem.

If quoting the medical literature to patients to explain a point of view, plus relying on years of experience, is being full of myself; I guess I am guilty.  If I do not respect the wishes of the family when the patient is fully competent to make decisions and is still the legal health care decision maker, than I am guilty as well.

When a patient chooses to leave my practice, I make it a point to send them an individual hand -written note.  I apologize for not meeting their needs and expectations and ask them to please let me know their grievances for the sake of improving the care and service and not repeating actions which a patient found to be negative. I ask “why” they left and if I did something that I should not have done, or did not do something that I should have done. After writing these notes, I have my office staff review them to make sure the tone and content are caring, inquisitive and appropriate.  Unfortunately, no one ever responds.

My friend, the practice advisor, felt it was important to identify these situations and try to further identify the author of each review.  He recommended, and I wholeheartedly agreed, it would be important to have a conversation with each of them to gain a better understanding of the situation, apologize and make any appropriate practice changes.

Since my staff and I are not able to put the pieces of these puzzles together, I am at a loss for identifying the authors.  Furthermore, these online sites do not typically allow a physician to confirm the author was, in fact, a patient and then respond to their review.

That’s a problem since 80% of patients who are seeking a new physician search online.  My advisor has shared with me countless examples of negative physician reviews where there was nothing to indicate the author had ever even been a patient of the practice.

A few years ago I experienced that myself on Angie’s List.  Fortunately, I was able to track down and contact the author and they admitted they and their spouse had never been my patients.  It was an error on their part which reflected poorly on me.  It took time and effort but we were eventually able to have the review removed.  That rarely happens.

If you are a patient who feels you have a gripe with your doctor, I urge you to call that physician or write that doctor and express your concerns and give them a chance to respond. Do that even if you wish to move on. It’s the only way a practice and doctor can improve.  We really do care.

And, if you are seeking a new physician, do not take online reviews at face value.  Gather as much information about the physician as possible and ask if you can have a short meeting with the doctor before making your choice.  That’s something that’s something I make available at my practice for anyone interested in concierge medicine.

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The 20 Minute Rule

To meet Federal patient satisfaction goals, our hospital administration is requiring community based physicians to give patient admission orders before we have a chance to see the patient. Patients who self-refer themselves to the emergency department, are evaluated by the emergency room staff, and who are determined to require admission must be admitted by their community physician within 20 minutes of receiving a call from the ER staff advising the patient requires admission. In most cases, the community physicians have no idea the patient is actually at the ER until they receive that call.

It is bad medicine to issue patient orders on a patient you have not seen, taken a history from or performed an examination on. To complicate matters, the hospital does not require physicians to actually come in and see the patient for 12 hours after admission.   Think about it, diagnostic and care orders are being given routinely by doctors who have not examined the patient. The doctors then have the latitude to not show up for half a day to actually do an onsite evaluation.

One of the cardinal rules of medical training is you should do a thorough history and exam before constructing a theory of the causes of an illness and instituting diagnostic and therapeutic measures. The local hospital rule is a direct effort of the hospital to control all aspects of patient care for financial gain. They are buying up practices, revamping medical staff bylaws by manipulating the rules and, filling the decision making committees and legislative physician groups with salaried doctors they control.

Hospitals perceive community based physicians who are advocates for their patients as a threat to their financial planning.  The goal is to drive out the community based physicians because they act as a check and balance to the designs of the hospital system working as advocates of their patients. Do not believe for one moment that the goals and aspirations of patients in a community setting are aligned with the goals and aspirations of hospital administration.

I recommend that citizens look into the politics of their local hospital system.  If you do not, you may find that your doctor can no longer take care of you when you are sickest and in need of those professional services provided by someone who knows you well. You may find that you are transported from the ER to the floor quickly but you may not get to see a doctor for half a day.

How should this policy be altered to make sense?  Staff physicians should have 90 minutes to arrive at the ER and assume the care of their patients. In critical life threatening situations requiring immediate intervention, hospital ER staff should be providing stabilizing care until the patient’s care team arrives.

Requiring doctors to give orders on patients they have not seen is bad medicine. Giving those same doctors 12 hours to show up is irresponsible.

Patient Advocacy – The Decision

My patient received notification of Aetna’s decision of our appeal.  The news was positive.  The appeal was approved.

I knew in my heart, regardless of the outcome, it was well worth the effort.