The Dangers of a "Zagat Guide" to Physicians

Read Maggie Mahar's essay on her HealthBeat Blog.

It's about how physician ratings services that look only at "trust, communication, availability, and environment" but fail to measure quality of care and health outcomes are not exactly what the patient ordered - or needs.

She concludes:

"A more credible version of what the Zagat system purports to be—a system that empowers patients to understand and manage their relationship to doctors—is the paradigm of shared decision-making.

Very briefly let me just say that: “shared decision making? is a process which allows doctor and patient to share valuable information. First, the doctor describes the relevant risks and benefits of all treatment alternatives, and the patient shares with the physician all relevant personal information that might make one treatment or side effect more or less tolerable than others. Numerous studies indicate that when patients have the opportunity to participate in medical decision making with their physician, the patient-physician dialogue improves, and patient well-being improves as well.

This is the real deal when it comes to empowering patients to take control of their “health care decision making.? Presumably a doctor who engages in shared decision making will score high on the metrics of trust and communication—no conflict there.

But from a long-term perspective, the reduction of medical care to Zagat snippets may be counter-productive with regards to moving toward shared decision making, because it reinforces the notion of health care as consumption. Treating doctors like restaurants perpetuates the notion that health care is like any other commodity: we want it fast and we want it now. In reality, real empowerment demands active engagement and a certain measure of personal responsibility.

The danger is that in relying on superficial measurements of service, patients will get comfortable with the quick fix approach, and we take two steps back with regards to truly integrating patients into health care as active participants."

About this Entry

This page contains a single entry by Gary Schwitzer published on October 24, 2007 8:45 AM.

The mis-labeling of "socialized medicine" was the previous entry in this blog.

Uncle Billy's Drug-Promoting Campfire Show is the next entry in this blog.

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