It's Come to This: Angie's List Health Care
Patients in America find that there is notoriously little public information about the quality of their medical care. A few common hospital procedures are more or less publicly rated by hospital, but you can't find stats on the greatest hospital danger, which is drug-resistant infections. Doctors? You can find a "completed" malpractice case, but the majority of such charges are settled before arbitration or trial, and never see the light of day. Prices are almost never available to the public. A few paid services purport to offer more, but actually just collect from the few public sources and individual consumer "reviews". Enter Angie's List, a paid subscription service built around consumer reviews of plumbers, contractors, decorators and the like.
Angie's List is advertising that it now also rates doctors and hospitals (insurance companies, too), not on medical expertise but on the consumer experience. Yet doctors, unlike plumbers, have the very lives of their customers in their hands. There's a strong bias for approving of your own doctor, because of the high stakes of the relationship. So just as with the children of Lake Woebegon, almost all of the few doctors rated so far on Angie's List rate an "A" grade on categories including "responsiveness" and "punctuality." Almost all of the few doctors, nursing facilities and hospitals rated so far have only one review entry.
Maybe the Angie's List health care section will grow into something useful, at a report of bedside manners, as it accumuates more ratings. Mostly, though, the ratings are just a symptom of how starved we all are for coherent information about medical quality. Not academic studies, but a Consumer Reports-style assessment of quality and efficacy. Not just of doctors and hospitals, but of treatments and drugs.
Since patients are at the bottom of the power rung in the medical-pharmaceutical industry complex, what they want and need too often comes last. If, that is, they can afford health care at all.
Take those drug-resistant infections, which kill an estimated 13,000 patients every year. U.S. private and mostly for-profit hospitals have avoided public reporting and federal rules with promises of weaker voluntary efforts. European governments, which have more control over health care, declared war and are winning against the infections, at least inside hospitals.
In Canada, whose public health care system is systematically maligned by the private U.S. medical industry, patients and their families in Ontario Province have access to hospital ratings on dozens of factors, from health outcomes to drug information. Ontario even covers the "patient satisfaction" categories of Angies List, but they cover every hospital, based on surveys of all patients.
Bottom line? When an industry is more powerful than its regulators, and patients less powerful than anyone else, the public scratches for crumbs of information--even on Angie's List.