Tuesday, April 27, 2010

Finding good primary care: beyond "best doctors" lists - Part 1 of 2

Every year, I receive a survey in the mail from Washingtonian Magazine asking me to nominate local primary care and specialty physician colleagues for the honor of being named one of Washington, DC's "Top Doctors." I usually send in a few names, and more often than not at least one of them ends up making the list. As a fellow family physician recently noted on his blog, these "top docs" lists are misleading at best, and useless at worst. By polling doctors about their opinions of colleagues, rather than the doctor's own patients, the list generators virtually guarantee that qualities other than name recognition - bedside manner, diagnostic ability, and knowledge of current research, for example - will have little impact on the rankings. (Incidentally, rankings of "Top Hospitals" also rely on reputation above all else, as a recent study reported in the Annals of Internal Medicine.)

Numerous websites now offer patients the opportunity to give and read about the true inside scoop on the "best" and "worst" doctors. These doctor review websites, however, provide little substantive information that isn't available on the website of your state's medical board, favor patients who have an axe to grind (since satisfied patients are less likely to write reviews), and as one physician columnist has noted, are stunningly easy to manipulate. Consumer Reports, they're not.

So how does a social media-savvy patient search for a new primary care physician when his or her insurance changes? Many innovative practices have launched increasingly sophisticated websites that, in addition to containing basic information such as types of insurance plans accepted, operating hours, and biographies of the doctors and staff, include links to online health risk appraisals, interactive Facebook and Twitter pages. In a future post, I will discuss some of the ways that primary care physicians are using social media to attract new patients and encourage current patients to stay healthy.