Com­plaints web­sites flawed, but demon­strate a need for peo­ple to speak

The Weekend Australian - Travel - - Health - MITCH MESSER

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

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