Complaints websites flawed, but demonstrate a need for people to speak
ANEW US-based website inviting people to post comments about their doctor is raising the ire of the medical profession in Australia. The cynical among us may not be surprised by a resistance among doctors to finding out what consumers really think of them. What might be surprising to some is that consumers are also voicing their concerns about this website.
The site allows consumers to rate their doctors on their punctuality, knowledge, helpfulness and overall quality of service. The comments are anonymous and can be viewed by anyone who accesses the site.
Doctors and consumers have focused on different issues in their criticism of the website. However, the concerns raised by both reveal something very important about the role of consumer feedback.
When calling for the website to be closed down, the Australian Medical Association (AMA) said its main concern was that the comments are anonymous, and so deny doctors an opportunity to respond.
Consumers have argued that while providing feedback on doctors’ services is important, this website risks becoming an ineffectual whinge-fest which achieves nothing in terms of healthcare gains.
So what is the answer? Do we need another way in which consumers can provide feedback to doctors on their service? The AMA argues that there are already channels for consumers to complain about sub-standard treatment, for example, via the medical board or health complaints body in each state and territory.
This may be so, but many consumers find that formal complaints processes are not easy to access or use. Also, some people report being labelled as ‘‘ problem patients’’ when making complaints against doctors, which can discourage them from speaking up when they feel they have received a poor service.
The end result is that many consumers do not complain directly to doctors, even when they are unhappy with the service they have received. This means that the doctor or health service never finds out that their patients are dissatisfied and cannot address their concerns in the future.
Of course, when things go wrong and someone is harmed in the process of receiving medical care, they should be entitled to seek acknowledgement and compensation for this harm through the legal system and other appropriate mechanisms.
But what about cases where consumers feel they have received less than optimum care from a doctor or health service, even though this has not resulted in any significant harm? Or when consumers are very happy with the care they have received and would like to acknowledge this and share it with others?
This is the type of information that can be useful in improving the performance of our health system. Without consumer feedback it is impossible to know whether a health service has improved in ways that are important to the people who use it.
Currently, there is no mechanism which encourages and supports consumers to systematically provide feedback on their experiences of health care. Often the only obvious options open to consumers are either to deal directly with their healthcare provider or to go down the route of making a formal complaint. Neither of these options encourages consumers to provide the sort of feedback that will lead to improving health care in the future.
Actively seeking feedback from consumers should not cause doctors any anxiety or concern. Both doctors and consumers have an interest in improving the quality of health care and both have an important role to play in achieving this goal.
However, the manner in which we obtain and use this feedback is important. New technologies and tools, such as websites and internet chat rooms, provide increasing opportunities for obtaining and disseminating information. It is important that these tools are used to their full potential to improve health care access and quality.
A ‘‘ doctor-rating’’ website may not be the answer, but it does indicate a need that is not being addressed. Closing the website down will simply suppress the symptoms, and not cure the underlying problem. A better approach would be to embrace the opportunities provided by new technologies and to find ways of obtaining and using consumer experiences which benefit both the providers and recipients of health care. Mitch Messer is chairman of the Consumers’ Health Forum of Australia