Mark S. DeFrancesco, MD, didn’t realize it, but sometimes he used to rest his hand on the doorknob while talking with patients at his Waterbury, Connecticut, gynecology practice. This unconscious habit gave the impression that his attention was already shifting to his next appointment.
A couple of patients mentioned the doorknob grasp in an anonymous office survey 10 years ago. As a result, DeFrancesco became aware of his habit and has worked to become a better listener. (He also now avoids the doorknob at all costs.) “If there’s something negative, I want to hear about it,” DeFrancesco says. “There’s no room for arrogance here.”
That’s why DeFrancesco and his colleagues in a large group practice, Women’s Health Connecticut (based in Avon), agreed to participate in a new medical ratings effort: the Zagat Health Survey.
From Dining to Health Care
Consumers already page through the famous Zagat guides for reliable restaurant and hotel suggestions. Now, they will be able to apply the same principles to find a five-star health care provider.
Although the Zagat Health Survey is not open to the general public, it will eventually be available online to 35 million people across the country who have WellPoint and/or Blue Cross/Anthem health insurance. WellPoint’s survey went live in January in three areas (Los Angeles, Cincinnati/Dayton, and Connecticut). Along with 150 physicians, 30 collaborative providers (advanced practice nurses, physician assistants, and nurse-midwives) will be evaluated on four criteria: trust, communication, availability, and environment. The best providers will receive a perfect score of 30.
“We launched this because consumer research indicated that peer-to-peer feedback was an important piece of the puzzle,” says WellPoint spokesperson Jill Becher. While similar online rating tools exist, WellPoint is the first health insurance company to partner with Zagat.
“We believe the methodology Zagat uses—and their expertise in assessing consumer experiences—is something that will strike a chord with our members,” Becher adds. Many WellPoint members already use Zagat guides in their daily lives, she says, so they will have confidence in the information offered on the Web site.
Rating Tools Are Booming
The WellPoint/Zagat survey is part of a growing trend toward online health care rating tools. Others include HealthGrades.com and Hospital Compare (www.hospitalcompare.hhs.gov). So who’s driving this movement? Look to the baby boomers, says Rick Wade, senior vice president of the American Hospital Association (AHA).
“They’re the best educated, most information-savvy, most affluent generation of senior citizens this country has ever known,” Wade says. “They have a totally different attitude toward the medical establishment than their parents did.”
The new Zagat survey should satisfy some of that demand for information, but it has a narrow focus. It is not designed to reflect hard data about the quality of care in a particular medical office, says Zagat spokesperson Betsy Haworth. Users won’t find any stats about board exams or malpractice claims. It’s more like word of mouth—people asking around to see if friends and family members know any good clinicians. “The goal here is to create a trusted resource that supports informed decision making,” Haworth says.
So far, Becher says, most patients are logging on to tell others about good experiences they’ve had with a clinician (rather than to complain). It’s still early, but Becher says the project will build momentum as WellPoint brings more patients on board in more cities. Providers like DeFrancesco also have been upbeat about it, she adds.
“What we’re really talking about here is an electronic patient-satisfaction survey,” DeFrancesco says. “We understand patient satisfaction is very important, so we welcome feedback and ideas. We’re not afraid of that.”
Speaking of Feedback
But officials at the American Medical Association (AMA) took a more negative view of the Zagat Health Survey. “Choosing a good physician is more complicated than choosing a good restaurant,” AMA President-Elect Nancy H. Nielson, MD, said in a recent statement. “Patients owe it to themselves to use the best available resources when making this important decision.”
Nielson raised concerns about the potential for fraudulent online posts. “Anonymous online opinions of physicians should be taken with a grain of salt and should certainly not be a patient’s sole source of information when looking for a new physician,” she said. For example, what happens if a mentally unstable patient or an angry competitor tries to post unfair comments about a provider?
Zagat and Wellpoint executives contend their online tool has safeguards and filters in place to prevent that type of scenario. In the end, they believe the benefits will outweigh any risks.
AMA officials say medical rating sites should offer information about quality of care, not just bedside manner and office decor. Instead, the AMA encourages consumers to seek several sources of information, such as checking with local medical socie-ties to confirm that a practitioner has a valid license. Asking another clinician for a referral or using the AMA’s DoctorFinder service might be better options, they advise.