When you are looking for a new provider, how do you decide who you will choose? Is it based on recommendations from family, friends, or advertising? Ads, yelp, or google? If you have stayed in the same city/state, many providers are well known and word of mouth gets around on who is a “good doctor” versus a “bad doctor.” Being a provider who moved from my home state to a new location and has had to start from scratch on making a name for myself and establishing my own practice,
I have found that many patients choose me based on recommendations, ratings, and comparing me with other providers. It is surprising to see how a provider's status is based on a ratings from patients and how that can influence one's future patient population and, overall, practice.
I do not believe a 5 star physician is always truly a 5 star physician. Some jobs base bonuses on satisfaction surveys. Comments and ratings are broadcast for all to see, good and bad. If one visit was not “perfect” or your plan of care differed in what the patient thought it should be, this can bring down your ratings, etc and reflect poorly on you from an outsider's perspective when others are googling for a “new doctor to see.” At my job, we have “patient satisfaction surveys.” Patients will be called and asked about their experience at their visit, etc. I think this is a great opportunity for patients to place their input; however, I do not think a physician should be judged based on just a rating or broadcast for the world to see. Sure, it feels good to get awards and acknowledgment based on “good scores” but this should not be a motive to provide better patient care. Throughout my years as a physician (and yes, I include that as a resident given I have only been out in practice for nearly two years), I have seen great physicians that provide excellent care, are wonderful surgeons, and act in the best interest of their patients. Some may not have the best bedside manner and because of that, they get poor ratings and vice versa. Don't get me wrong, I feel doctors should be able to establish a connection with their patients to better develop that relationship to allow an overall better experience with their care; however, it does make you wonder a few things...
It has been proven that a doctor with a better bedside manner is less likely to be sued even in an extremely poor outcome and poor patient care. Therefore, I sometimes wonder—are some 5 star physicians the best physicians or do they just satisfy a patient's expectation?
I recently listened to a podcast called “Dr. Death.” I was flabbergasted as I continued to go through the podcast series. This physician had great reviews, recommendations, etc—looked outstanding on paper; but was one of the worst physicians, surgeons, and human beings I have ever come across. I know this story may be an outlier of a situation, but after listening to this podcast, it made me reflect on my own experiences.
When you have patients get upset with you because you do not give into their requests although you know it is not the best treatment for them:
--Not giving a smoker over age 35 hormone replacement therapy due to extreme risks to her health
--Counseling a pregnant woman on smoking cessation and explaining the risks to her and her baby at every visit regardless if she still declines quitting
--Discussing risks of obesity to a patient's health and counseling on abnormal lab values and the need for weight loss
--Discussion of appropriate pain management and alternative options other than opioids to deal with pain
These a just a few examples I can think of among many I have faced even resulting in some patients changing care because of my counseling and recommendations on evidence based medicine. However, although these are uncomfortable conversations, I know I am looking out for the best interest of my patients and most of them can see and appreciate that. Doctors are human. We make mistakes. Hopefully, we learn from those mistakes and decisions and use that to better ourselves and in our future practice.
It is hard to know that your reputation can be based on one experience or bad rating. We tend to identify ourselves by what others think and say about us and it takes a conscious effort to not do that. I have learned while being out in practice to not dwell on a bad comment or if you get pushback on a decision that you know is right. When I became a doctor, I took an oath and I continue to practice by that oath.
I am going to continue to practice in the best interest and safety of my patients, will continue to counsel even in uncomfortable situations even if it may not be what they want to hear. If that gets me good comments/ratings, great; if that gets me bad comments/ratings because I did not give into giving a medication, performing unnecessary labwork or procedures at a patient's request, or because I continually counsel someone to hopefully better their health, then so be it.
At the end of the day, I know that I did all I can do for my patients, and to me, that makes me a 5 star physician.
-Dr. Riley
