I Want Great Care .... or do I?

Lots of flim flam in the news about Neil Bacon's latest venture IWantGreatCare.org.uk

This is the new website where you can say pretty much anything you like about  any doctor registered  in the UK. Lots of indignant docs expressing outrage. The Patients Association sounding off with approval. Its also interesting because lots of people in the past have asked us whether Patient Opinion was going to produce a 'name your doctor' facility so over the years we've given quite a lot of thought to the pros and cons of this approach.

So what do we think? First off doctors - and every other professional -  need to recognise that they can't stop this kind of comment. And if IWantGreatCare fails or is sued out of exisitence there will always be RateMDs.com the American site that recently came to the UK and which - being covered by US rather than English libel laws - is perhaps more likely to last. 

But the deeper question is what do sites like IWantGreatCare actually achieve? Ostensibly they are about helping patients choose a doctor but there are a couple of crucial problems with this logic.

1. In the UK it is almost impossible to choose to see - or avoid - a particular named NHS doctor, other than a GP. Over the last decade Trusts have forced GPs to refer to the speciality not a particular doctor. This is because its much easier to maximise efficient use of out patient slots  when all referrals are in a single list than in 8 different lists for 8 different consultants. For the same reasons Choose and Book, the electronic referral and booking system, makes it very hard to for GPs to refer you  to a named doctor. 

 2. The deeper question is how much information about individual doctors does such feedback carry? Look at RateMDs.com who already carry lots of comments about lots of doctors and you'll usually  see that very critical comments about a doctor are quickly followed by an equal number of glowing reports. So what's Jo Patient meant to make of this? How much does it really help people reading these kind of comments?

So what  will IWantGreatCare actually achieve? Well two outcomes are likely. Firstly some patients who want to sound off about their doctors will love it. Others may want to express gratitude. The overall tenor of the site will reflect the balance between these two types of comment. 

Secondly doctors themselves are likely to find the site undermining. Good comments will be discounted whilst bad will tend to expand to fill available consciousness. 

There is a clear risk that in the long run  sites like this will devolve to serving the lowest common denominator of outrage. As such they will serve some kind of purpose but wise doctors, or at least those who want to sleep well at night, will either grow very thick skins (which is not good for their professional practice) or studiously ignore the sites altogether. In both  cases the sites loose any wider value.   

Its also worth noting the significant differences to Patient Opinion. Firstly on PO comments are tagged to department, ward or site rather than individuals. This makes critical comments easier to hear and easier to bear. Secondly because the comment is directed to the whole service stories often  indicate very practical solutions that are focused on the system not the individual. All this delivers a site where your comment as a patient can actually improve services for everyone.