What falling ratings mean for physicians in practice

One of the most soul-damaging events for a physician is being sued by a patient with a bad outcome - particularly when the physician cannot think in hindsight how he or she would have done anything differently. I've witnessed the enduring and confidence-shaking psychological trauma up close and personal in physician clients, friends and colleagues!

Another potentially disturbing trend, described in the LA Times a few weeks back in an article titled "Doctor ratings: Is your healthcare hot or not?", is that of public ratings of physicians and their practices. 

Or should we say in some cases public beratings!

"Patients and site operators say the trend is good for consumers and good for healthcare. Thoughtful doctors, they say, will provide better customer service because of the feedback, and the bad ones will no longer be able to hide. And, they add, why should doctors be immune from the trend toward better customer service?

Physicians aren't so sure of such reasoning. Many say the reviews on RateMDs.com, Vitals.com, DrScore.com and other sites are skewed by disgruntled patients and are thus unfair, pushing some doctors to near-ruin after a single post."

The article goes on to debate the rights of patients as consumers to know who they are entrusting their care to (valid point) versus the challenge physicians face when they are criticized unfairly (in their minds) and unable to vent back, for fear of violating patient privacy rights.

I wrote previously about how Zagat has teamed up with Wellpoint to create a physician rating system.

Are these broken solutions for a broken system?

I was glad to see mention made of Medical Justice, a NC company started by Dr. Jeff Segal, whom I had interviewed almost two years ago, when his company was getting off the ground, for Conversations with Trailblazers.

To protect himself, Fischel recently signed up for services with Medical Justice, a Greensboro, N.C., company that provides doctors with contracts and services to guard against frivolous malpractice lawsuits. Last year, the company designed a contract doctors can use asking their patients to "respect their physician's privacy on the Internet" by not participating in online ratings.

If a contract is in place beforehand, a doctor can force a website to take down the offending material, says Dr. Jeffrey Segal, a physician who runs the company.

To a doctor, reputation is everything, Segal says, adding that doctors shouldn't bear the brunt of dissatisfaction with the faltering healthcare system.

"All stakeholders -- consumers, doctors and payers -- are frustrated right now," Segal says. "Because of that there is a lot of finger-pointing and a lot of anger, some of which is unproductive."

(Emphasis mine)

Bravo again to Dr. Segal for standing up for physicians whose professional lives are thrown into turmoil by recognized bad outcomes and frivolous suits.

And by the way, who is taking responsibility of ensuring the fairness and objectivity necessary to make these rating systems useful?

Can the Web combat fragmentation in US healthcare?

One enterprising and industrious physician believes it can.

Neurosurgeon Dr. Louis Cornacchia doesn't just want to save your brain or spine; he's wants to save medicine from itself. Frustrated by the diminished power of physicians in the current healthcare system and the increasing disconnect between physicians and patients, he has been on a 9-year journey to find sustainable and effective solutions.

After extensive research and consultation with physician colleagues, patients ("consumers" of healthcare), attorneys, technogeeks and business people, he and his partners have concluded that the only successful path to a healthcare revolution is via the connectivity and continuity provided by web-based technology platforms.

As a founder of Doctations, Dr. Cornacchia speaks about his journey to entrepreneurship that began with a series of annoying and unnecessary interactions in the hospital around providing patient care, and his vision for the company in this week's 25-minute Entrepreneurial MD Podcast.

The somewhat challenging concepts are best captured in the company's Mission Statement:

Doctations, Inc. intends to further leverage the power of the Internet to improve the efficiency, accessibility and quality of healthcare delivery and doctor-patient interactions, with an initial focus on Internet-enabled digital medical records (iDMR) and automation of physician offices using outsourced services provided by a distributed, independent domestic workforce. A strong doctor-patient relationship is key to improving the delivery of excellent healthcare. The Doctations software suite allows doctors to use the Internet to establish Centers of Excellence and to help decrease the global cost of healthcare.

Doctors + Other Provider Organizations + Patients = Web Integrated Healthcare Communities

Practicing physicians can immediately begin using the platform for free, while patients and their families can set up their records at www.iMedicalHome.com (also free) - want to try it out?

After listening to the podcast, please come back and share your thoughts.

Does being a happy doctor make you a better clinician?

Well, it must be video week - I continue to discover the gems hidden in the treasure trove called YouTube.

This video, The Happiness Advantage (click on the link to play it as it can't be embedded), from Shawn Achor, a researcher and teacher of positive psychology from Harvard University is a part of his series on The Science of Happiness.

Warning - the video is very loud when it first starts!

What brings this particular video home is the emphasis on the relationship between physician happiness and productivity, speed of reaching a diagnosis, and quality of medical care provided. You'll spend an insightful 10 minutes listening.

The rest of the series bears listening too (check them out on the right hand side of the YouTube page -- they're 8 to 9 minutes long each) - they present a somber view of the rate of depression in contemporary America, as well as a fascinating insight into how our brains function when hardwired for happiness. Medical students and physicians feature prominently in these stories too!

The short and sweet version - those who are happy outperform those who are unhappy by 50%. You are more creative AND more intelligence by all measures when you are happy. You are much less likely to burn out despite external stress. There is a true happiness advantage!

Isn't it worth trying to put a smile on your face?

The million-dollar question for entrepreneurial physicians

In response to the question I ask of anyone opting in for my "Crack the Code to Becoming an Entrepreneurial Physician" free report (I ask: "What is your BIGGEST question about starting or managing a business?"), I received this great reply the other day:

My biggest question about starting or managing a business is whether or not the business I am considering will thrive for the long-term and be able to provide significant financial support (or be a side business).  I do not feel that I have a great business background so it's hard trying to figure out "where do I start".

This was my reply:

The best chance for success occur when you have the following:

1. a well-defined problem you are solving
2. a well- and clearly-defined target market with that problem that you care enough about to want to solve their problem(s)
3. a target market that can afford to pay for your solution, and values your solution
4. a relatively easy way to access your target market without having to find them all one by one, unless you have a really high ticket item you can sell and then deliver without much overhead (consultants can sometimes do this - just one $50,000 or $100,000 project can be enough, and you have to usually find your customers one on one for those)
5. a clear message about the benefits of your solution, with a plan for how to get that message out (your marketing plan)
6. a clear business plan that outlines your business model, what you have discovered about 1-4 above, your path to revenues, your anticipated costs, your financing, and your team (of advisors or employees)
7. sheer tenacity and dogged persistence to weather the rough times
8. and a touch of luck will help!

Do you agree? 

Watch your words!

It is rare that I struggle to swallow, for the lump in my throat, or see the screen for the film of tears in my eyes while sitting in front of my computer. A few minutes ago, I had such an experience, and I want to share it with you.

(thanks to Jonathan Fields of Awake at the Wheel for making me aware of this video).

Coming from South Africa, I feel great pain about the societal judgments I was raised listening to. I hope I can do better with my daughter, but I realize it's a challenge. Thanks to those who have reminded me of the power of words.

I'd love to hear your thoughts!