{"id":423,"date":"2008-07-25T17:04:11","date_gmt":"2008-07-25T16:04:11","guid":{"rendered":"https:\/\/blogs.bmj.com\/bmj\/?p=423"},"modified":"2008-07-31T11:19:53","modified_gmt":"2008-07-31T10:19:53","slug":"deborah-cohen-i-want-great-care","status":"publish","type":"post","link":"https:\/\/blogs.bmj.com\/bmj\/2008\/07\/25\/deborah-cohen-i-want-great-care\/","title":{"rendered":"Deborah Cohen: I want great care"},"content":{"rendered":"<p><img loading=\"lazy\" decoding=\"async\" src=\"http:\/\/www.bmj.com\/channels\/icons\/debcohen.jpg\" alt=\"Deborah Cohen\" width=\"160\" height=\"110\" align=\"left\" \/> We\u2019re used to checking out the internet for the lowdown on our holiday destinations or theatre review, but what about finding yourself a good doc? Tapping into the government\u2019s Choice agenda (see Michael Cross\u2019 BMJ <a title=\"How the internet is changing healthcare\" href=\"http:\/\/www.bmj.com\/cgi\/content\/extract\/337\/jul22_3\/a883\" target=\"_blank\">feature<\/a>), the website <a href=\"http:\/\/www.iwantgreatcare.org\">www.iwantgreatcare.org<\/a> is the brainchild of <a title=\"doctors.net\" href=\"http:\/\/www.doctors.net.uk\/\" target=\"_blank\">doctors.net <\/a>founder and former hospital doctor, Dr Neil Bacon. According to Bacon, its aim is to empower: \u201cpatients to share their experience, knowledge and opinions [so] we can drive changes and improvements in the health service that will benefit all\u201d.<\/p>\n<p><!--more--><\/p>\n<p>It\u2019s a slightly different beast to the <a title=\"NHS Choices\" href=\"http:\/\/www.nhs.uk\/Pages\/homepage.aspx\" target=\"_blank\">NHS Choices <\/a>website\u2014rather less emphasis on objective \u201chard nosed\u201d outcome measures, as the NHS\u2019s medical director, <a title=\"Sir Bruce Keogh\" href=\"http:\/\/www.bmj.com\/cgi\/content\/extract\/336\/7659\/1464?maxtoshow=&amp;HITS=10&amp;hits=10&amp;RESULTFORMAT=&amp;fulltext=timmins&amp;searchid=1&amp;FIRSTINDEX=10&amp;resourcetype=HWCIT\" target=\"_blank\">Sir Bruce Keogh<\/a>, might say\u2014and offers an opportunity \u201cfor doctor&#8217;s patients, patients&#8217; carers and relatives and colleagues\u201d to rate doctors using \u201cobjective criteria derived from the evidence base for patient satisfaction\u201d.<\/p>\n<p>These measurements are sliding scales rating trust, listening ability and one measuring how highly the user recommends the doctor. There\u2019s also a free text box asking the user to share their experience in as much detail as possible. It\u00a0asks the user\u00a0to mention what\u2019s great about their doctor and what they could do to improve. So how do these objective criteria really measure up? Answers at the end of this blog, please.<\/p>\n<p>Except for the sound of silence from government ranks and the odd plaudit from a political pundit, such as the <a title=\"HSJ\" href=\"http:\/\/www.hsj.co.uk\/\" target=\"_blank\">Health Services Journal <\/a>and <a title=\"The Guardian\" href=\"http:\/\/www.guardian.co.uk\/\" target=\"_blank\">Guardian<\/a> columnist\u00a0<a title=\"Michael White\" href=\"http:\/\/www.hsj.co.uk\/opinion\/columnists\/2008\/07\/michael_white_on_rating_doctors.html\" target=\"_blank\">Michael White<\/a>\u2014\u201cThe British Medical Association was quick to condemn the idea\u2014so it can\u2019t be all bad\u201d\u2014 its arrival amongst the pages of other ratings websites has been greeted with a hostile response.<\/p>\n<p>The tables have been turned on Dr Bacon himself. <a title=\"Dr Rant\" href=\"http:\/\/www.drrant.net\/\" target=\"_blank\">Dr Rant<\/a>\u00a0has posted up a screengrab featuring Bacon with a 0% rating and another site ridiculing the concept has sprung up: <a href=\"http:\/\/www.iwantgreatbacon.com\">www.iwantgreatbacon.com<\/a>.<\/p>\n<p>Harsh, perhaps. But with all the vitriol spewed out daily on doctors.net, what did he really expect? The site where the failed Glasgow bombers were called \u201cbeardy weirdies\u201d and paediatricians list their favourite \u201cchav baby names\u201d. He was hardly going to get a mild rebuke from the 5% of doctors he claims are not behind the project.<\/p>\n<p>Away from the specialist medical bloggers and press, <a title=\"Shinyred\" href=\"http:\/\/www.shinyred.tv\/2008\/07\/15\/new-website-iwantgreatcareorg\/\" target=\"_blank\">Shinyred<\/a>, which focuses on new media, points out, reviewing is slightly different with doctors\u2014choosing your doctor is a longer term commitment and your health is pretty important to boot.<\/p>\n<p>But another blogger on the same site is dismissive of the criticism. \u201cPeople exercise human judgment on reviews shown, if a doctor has ridiculously flattering reviews from EVERYONE it would be pretty suspect,\u201d he says. \u201cLikewise with BAD reviews, we as human users can actually make a judgment. What happens in the real world? We listen to other opinions but we don\u2019t just blindly follow them do we? So lets embrace these types of resources they can only make it better for us all in the long run.\u201d<\/p>\n<p>And why shouldn\u2019t patients have the right to know who the failing or bad doctors are? And shouldn\u2019t doctors be as accountable to the public as anyone else paid for by the national purse? This in itself is central to the Darzi mantra of openness and accountability.<\/p>\n<p>But it\u2019s doubtful if the website will provide any meaningful data and will drive up performance. The <a title=\"Ferret fancier\" href=\"http:\/\/ferretfancier.blogspot.com\/2008\/07\/iwantgreatcare-farce-in-making.html\" target=\"_blank\">ferret fancier<\/a> says: \u201cThose like myself who work on the front line are already very accountable for our actions, it is remarkably easy for a patient to complain given the mechanisms in place, the argument that Iwantgreatcare will improve patient care is disingenuous\u201d. The likelihood with a website such as this is it\u2019ll attract those with a major crush on their doctor or those with an axe to grind \u2013 which will no doubt subsequently be removed when the doctor in question lodges a complaint or libel action.<\/p>\n<p>Which is what has the BMA up in arms\u2014doctors are bound by different codes of conduct. Other people or companies have the option to respond if they see fit. But doctors are bound by confidentiality and if they get a stinging review by a patient\u2014and it\u2019s unfounded\u2014a doctor can\u2019t respond. It\u2019s much the same as already happens in the press\u2014allegation from a patient, doctor can\u2019t comment.<\/p>\n<p>The BMA\u2019s concern is that the site could leave doctors open to abuse, libel and even personal attack. One group of doctors has already sought legal advice to block it and <a title=\"Dr Crippen\" href=\"http:\/\/nhsblogdoc.blogspot.com\/\" target=\"_blank\">Dr Crippen <\/a>is keeping a blog of all defamatory comments made about doctors. The goal? Maybe one libel action will force the site to close.<\/p>\n<p>What the end result will be remains to be seen. Whether this site will drive up standards is uncertain, but it will bolstering the coffers of media lawyers. If the glut of doctors rating sites in the US and Germany is anything to go by, it\u2019ll be bad news for doctors and good news for lawyers. So what do you think? Will this affect your clinical practice? Or have you dismissed it as a money spinner for one former hospital doctor with an eye for a headline?<\/p>\n<p><a title=\"Deborah Cohen\" href=\"http:\/\/resources.bmj.com\/bmj\/about-bmj\/people\/editorial-team\/deborah-cohen\">Deborah Cohen<\/a> is Features Editori, BMJ<\/p>\n","protected":false},"excerpt":{"rendered":"<p>We\u2019re used to checking out the internet for the lowdown on our holiday destinations or theatre review, but what about finding yourself a good doc? Tapping into the government\u2019s Choice [&#8230;]<\/p>\n<p><a class=\"btn btn-secondary understrap-read-more-link\" href=\"https:\/\/blogs.bmj.com\/bmj\/2008\/07\/25\/deborah-cohen-i-want-great-care\/\">More&#8230;<\/a><\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[116],"tags":[301,303,302,299,298,300],"class_list":["post-423","post","type-post","status-publish","format-standard","hentry","category-editors-at-large","tag-choice","tag-darzi","tag-doctors","tag-iwantgreatcare","tag-neil-bacon","tag-outcome-measurements"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.3 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>Deborah Cohen: I want great care - The BMJ<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/blogs.bmj.com\/bmj\/2008\/07\/25\/deborah-cohen-i-want-great-care\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Deborah Cohen: I want great care - The BMJ\" \/>\n<meta property=\"og:description\" content=\"We\u2019re used to checking out the internet for the lowdown on our holiday destinations or theatre review, but what about finding yourself a good doc? 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