Friday, May 21, 2010

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

Aware of the limited amount of reliable data about physicians online, many practices have decided to cut out the middleman and market their services to patients directly. Increasingly, practice websites contain more than basic information such as contact phone numbers and hours of operation. For example, Maryland's Potomac Physician Associates maintains separate web pages for each their three offices that contain physician biographies, a list of accepted health insurance plans, and FAQs such as guidance for caring for a child at home with H1N1 influenza.

Patient First, which operates multiple offices in Virginia and Maryland, displays each doctor’s schedule and offers links to news items about the practice and the websites of authoritative government and private health organizations. A primary care house call practice for the homebound elderly in Washington, DC posted an award-winning YouTube video describing the benefits of its services on patients’ lives.

Even for family physicians who don’t have the time or resources to incorporate many bells and whistles into a practice web page, it is a simple matter to refer patients to social media sources that can help them to stay healthy. The various institutes of the National Institutes of Health, the Centers for Disease Control and Prevention, and the Agency for Healthcare Research and Quality all maintain active Twitter and/or Facebook accounts to rapidly disseminate breaking news and other information relevant to patient care.

Preventive counseling to promote healthy and discourage unhealthy lifestyle behaviors lends itself especially well to “micro-blogging.” Smokers who are seeking support to quit the habit can exchange tips with thousands of fellow nicotine addicts at; patients with alcohol problems can join a “virtual AA group” at; and anyone interested in improving their physical fitness can find lifestyle coaches and personal trainers at

While it is difficult to forecast the directions in which online patient-physician interactions will evolve in the future, one lesson is already abundantly clear: establishing an interactive, informative online presence is far more likely to recruit and retain satisfied patients than leaving one’s reputation to the mercy of doctor rating websites.


  1. Rankings, of doctors, hospitals, or medical schools, by US News, etc., are all done very subjectively. (see blog Rankings of Medical Schools: Do they tell us anythings?" Medicine and Social Justice, Sept 25, 2009).
    Did you ever notice how the "best" doctors, especially those in airline magazines, always practice in elite areas (Fifth Ave., N. Michigan Ave., Rodeo Dr.) and how this does not mesh with your medical school memories of who went into practice where? While people assume that rich people must have the best doctors (after all, they have the best cars and houses!) I would say that doctors who practice with the rich do it because that is what they want to do (and make money) and that those practicing with the poor are often as good or better.

  2. I suppose the question then becomes (as a family physician colleague of mine observed) - is there any systematic and reliable way for an ordinary person without "insider knowledge" to select a doctor? We take great care when selecting schools for our kids, places to live, cars, etc. and for these can use rankings that most people agree on. But for doctors the process seems entirely random - why? More variables, less information, or both?