To want MNHQ to get rid of the link to 'I want great care'?

[sallysparrow157]

It's an awful awful website. It is not moderated or validated. Doctors at times have to do things that patients don't like (ie sectioning someone mentally ill, not prescribing methadone for someone who is still using heroin as some extreme examples but even things like not giving antibiotics for a viral infection or not referring someone to something inappropriate), this doesn't make them bad, in fact it makes them better doctors than someone who will do something they think is wrong just to keep the patients happy. However, anyone who has been annoyed by their doctor can post on this site and write whatever abusive things they like and there is no way for the doctor involved to respond.
It is not kept up to date - there are doctors who have been entered as the wrong speciality, doctors down as still practicing who have retired and doctors who have actually been entered on the site after their own death. Relatives of these doctors have contacted the people who run the site and asked for their details to be removed as it is obviously upsetting to know that anyone who fancies it can write abuse on the internet about your dead father, the people who run the site have not done anything about it.
I am a doctor. I undergo constant monitoring of how I do my job, both the clinical side of things and how I communicate with patients and their families. There is an effective complaints/feedback system so if my patients think I am doing something wrong they have a way of letting me know this so I can improve. So I'm not being precious and not wanting anyone to say horrible things about me. I just think that this website is a good way to spout anonymous hatred online about named professionals, if you are that way inclined, and as it is not updated and contains the details of dead and retired doctors but does not contain the details of many doctors working today (including me and everyone else who works in my department - apparently there are no paediatricians in this city...), it is also completely useless.
I'm very disappointed that mumsnet has chosen to publicise it.

I have a recent experience of seeking opinions about a HCP. A couple of my friends in the village warned me that our local health visitor was a bit of a cold fish, and didn't really make it seem like she was interested in people's children. So I went to one of her clinics, found that, yes, she comes across as very uncaring and distant, so I go into the nearby town to a baby clinic there, with a lovely HV. I've mentioned to my MW and GP that I find this HV difficult, and this has been added to some other complaints from our area.

However, a personal attack on this person on t'interweb would, in my opinion, be cruel. She needs a bit of advice from her peers, and perhaps some retraining, not lambasting in cyberspace, which would forever tarnish her reputation. And, as I'm sure we all agree from experience on this site, people tend to be far more insulting and, yes, downright bitchy, when they have the security of internet anonimity to hide behind.

I also have switched GPs when I simply didn't warm to the one I was allocated. But that's why surgeries have several GPs and the option of changing. If one particular GP is often refused by patients, it's down to the practise manager to identify a problem and follow it up.

I agree, Justine, that for consumer goods and services, internet reviews are the way forward. But for something as serious as medical provision, there should be correct channels and procedures, subject to legistlation and governing bodies. This site just serves to undermine those.

I don't think people move on the basis of the reviews of a doctors surgery though. I do think people move with how CLOSE the nearest doctors surgery is in mind, just for convenience when ill, not for how good some random people on the internet think they are.

Also WRT to the schools review idea. I do not agree this is a good idea for a few reasons. There is already schools league tables out there that review, monitor and look at all aspects of school life. OFSTED reports too, they indicate a good school (or bad depending on the report). I also feel that a review of schools (especially if just a thread on mumsnet) would give a lot away about the user (taking away some anonimity (sp?)) with the location of the school, how many children a MNer has had through the school. People do move to get their children into a good school, but i do not feel a review section would be helpful in anyway.

The fact that the site is one you have to build up yourself, is harmful too. What is to stop a doctor intent on taking peoples lives (extreme case i know - but think Harold Shipman, or those that aren't good doctors and know they are not) on putting reviews of themselves and their surgery saying that they are great? It may be moderated but the person posting is a real doctor with REAL qualifications (unlike the guy pretty much pretending [deception - people get locked up for that]) that are misleading the company.

I think that there is enough information on the NHS website, that is well moderated and is fully accountable.

Bad move MN, bad choice, very disappointed and concerned. Especially if a MNer did use the site and fell into the hands of a terrible doctor who wrote fantastic reviews about themselves

@CinnabarRed

Justine - you're misunderstanding the whole basis of "the wisdom of crowds".

It breaks down when either views are biased one way or the other (as has been pointed out repeatedly here, review sites such as this are many times more likely to get complaints rather than praise down to simple human nature) and/or where "group think" makes people ignore sometimes overwhelming evidence to the contrary in favor of following the direction of the crowd (again the usual example given is 9/11 where literally thousands of people in security services around the world, some of whom had more than enough information to understand the danger, failed to act).

I'm just not sure that's necessarily true - I think people are very ready to praise things if they've had a good experience - if you look at patient opinion it's choc full of positive reviews...

(Un)interestingly enough, I've moved a few times fairly recently. Always in or into big towns or cities with lots of doctors' surgeries.

I've never used iwantblahblah. Last time, I used the NHS site to find all surgeries within a mile radius of my postcode. There were lots. Then I clicked the "accepting new patients" box, which trimmed it down quite a bit.

Then I clicked the "accessibility" box because at the time, I couldn't get up and down flights of stairs. After that, I chose the surgery I thought I could get to most easily and safely with ill children in snowy weather.

I registered at that surgery, and got randomly assigned to a doctor. However, when I actually need to see the doctor, I just see whoever is free at the time I can get to the surgery.

agree with cinn though its kid of a moot point now, you might go to your dr's 100 times and everything will be great and lovely and then one time he/she say or does some thing to piss you off. thats the time you will go to that site and rant about because you want to get it off your chest. not the 100 other times were it has been absolutely fine.
its human nature to only really talk about the bad stuff.

And please make sure that, when you dissolve this ridiculous partnership, IWGC doesn't continue to claim that it's endorsed by MN...

really justine? aibu is choc full of women extolling the virtues of their dp's . doesnt mean they are lovely most of the time. they just dont often come on to do a aibu to have a lovely partner because its not as interesting.
i agree that if a dr went above and beyond then some one might be moved to make a positive comment but if there every day contact was just some one quietly doing their job well that is unlikely to garner positive reviews.

doesnt mean they are not lovely...

spooks gotta agree with that one, and apply it to MN. How many times do you come home from work after a shitty day/shitty day with the kids and blow off about your day/who/what has pissed you off?

How many times after a truly sparkling day do you come on MN and go on about how great you feel after the most fantastic day? As you say human nature.

*whomever, sorry!

Justine, it doesn't matter if PatientOpinion is full of positive reviews! You can only treat that as a valid basis of judgement if equal proportions of people who've had positive experiences post as the proportion who've had bad experiences. Otherwise the whole site will still suffer from self-selection bias. That's the whole bloody point.

Look, it's like this. Suppose 100 patients visit a doctor in one week. 90 are happy with the outcome and 10 are not. On average, human nature being what it is, we would expect 1 of the dissatisfied to post on a review site, and one of the satisfied. So, based purely on the site reviews, it looks like 50% of patients aren't happy with their doctor. Which is completely misleading as in fact 90% are satisfied.

And, actually, that brings me on to another flaw in your logic! (Quite aside from the others that several people have pointed out already.)

In real time, too few people will interact with a given doctor to create a statistically valid sample (or crowd, if you prefer).

In contrast, potentuallt several thousand will read a given book on Amazon or visit a given hotel.

So you can't compare TripAdvisor to IWGC in any case.

To be honest, I could give positive reviews of most medical professionals I've encountered, but for all I know, their treatment and prescriptions might have been abysmal. Maybe I've just been lucky to suffer no side-effects.

When it comes down to it, I'd be rating them purely on whether they were nice or condescending to me, and their skill in giving explanations.

The other thing is it entirely depends on your interaction with a doctor. If for example I have a five minute consult with a cardiologist and he is brusque with me, bad review. If he was rushing to get to an emergency and saved that person, I'm guessing that person who will have experienced more of his skills, will give a glowing report.

Conversely, just because the outcome was bad doesn't mean the care was bad. The doctor who treated my grandmother was amazing. She still died. But she didn't die in pain. For me, his care was good, he was there when we needed him and had the knowledge and judgement to make decisions about her care when we couldn't which gave her a good death.

And good care if often overlooked. The GP that deals with childhood snuffles with good cheer and the occasional prescription is ignored over the GP who tells you to get off your fat arse and go to the gym now and then.

My GP is entirely unremarkable. He's nice enough. Don't see him very often, but I don't feel I can make judgements on his treatment because he, like a good mechanic, keeps me ticking over, only intervening when required. Why would I review that. And who would be able to judge a doctor based on that?

Well I do think it would be good to have a review site for Drs/ medical professions. People can use the feedback as and when they want, paying more attention to some bits that resonant for them and edit out the posts that don't (as we all do with threads on MN).

I just don't think Drs are being realistic if they can avoid people reviewing them online. Currently if I googled my Drs surgery it would come up on NHS choices, a local forum for my neighbourhood, probably on MN, someones blog etc. I could read all these and aggregate my own opinions. A good health care review site (yes, it might not exist yet) would simply cut out the leg work.

Whether people are in favour of greater choice or not (or think it works in practice - I'm not convinced), it's here, and from what I understand of the healthcare reforms (not much) more is coming, so isn't it right that patients have more info. on which to choose?

Now I think about the "crowd review" issue, I wonder whether people don't complain more/use the site for moaning when they are reviewing state-funded services (so, in the UK, NHS doctors and state schools) than when they are reviewing market-based professional services. When I have spent a lot of money something but am pleased with the result, I am more inclined to tell other people about money I chose to spend than when I have used a state service for which I had no choice but to pay through my taxes.

Justine.

I've said I don't think the database issue is insurmountable - it's a question of more input

No, its more than that. Much more. The concept is fundamentally flawed as the way it is set up, in combination with the way that doctors work, will never result in an accurate database. Not only that, but the whole concept of people adding their own entries for doctors, at different work places makes for seriously dodgy entries. The only way this could possibly be even slightly accurate is to take the database directly from the GMC register, with a single antry for each doctor, and it would have to be updated constantly. Not only would the cost of that be prohibitive, it would also be strongly opposed, and probably illegal, under data protection laws. It ain't ever going to happen, believe me.

By the way, do you have any idea of the mumber of times I've had a patient swear blind that it was me that they saw last week and gave them so and so that didn't work, when in fact it was a colleague (even a male colleague sometimes!)

I fear how this issue is resolved and everything said around it may be the making or breaking of MN for a lot of people

I agree with CinnibarRed's views on the widsom of crowds, and agree that the IWGC site will not achieve that.

I used to work in NHS management and had responsibility for 'patient feedback' (complaints). There were 2 main difficulties - one was that people are much more likey to provide feedback if they are unhappy with the service, than if they are happy, so it was never a balanced view; and secondly that people feel empowered mainly to comment on things that they understood - so they would comment on chairs, reading material, rude receptionists, poor spelling, long waiting times, but they did not feel so able to comment on technical / medical aspects of their care.

Valuable patient feedback is now being through systematic reviews of 'patient journeys' where all aspects of their experience are recorded and reviewed.

crumblemum 'I just don't think Drs are being realistic if they can avoid people reviewing them online. Currently if I googled my Drs surgery it would come up on NHS choices, a local forum for my neighbourhood, probably on MN, someones blog etc. I could read all these and aggregate my own opinions. A good health care review site (yes, it might not exist yet) would simply cut out the leg work.'

Your surgery would, yes. Not the individual. Thats kind of the point. I can see the value, although recognise the limitation, of reviews of institutions, surgeries etc. But NOT the individuals.

A very brief google search finds two (admittedly American)big surveys (2009 & 2011) showing that in ALL non-retail services people are far more likely to share negative experiences than positive UNLESS prompted.
Looking at these surveys this effect is strongest in healthcare.
'Nuff said.

That was the fact that struck me most forcefully, too, CinnabarRed: that too few people can input data about an individual doctor for the rating to have any statistical robustness (even if the Mumsnet link increased IWGC's traffic immensely. It is like the time when Westbury became the murder capital of the UK -- not because it had any genmeral properties at all that were conducive to a murdery kind of experience if you chose it, but because murder numbers are low enough to generate a constant flow of statistical absurdities of that sort.

The other and much more crushing vileness of the site is that it is premised on the market-obsessive idea that everything can be evaluated in terms of concatenations of preferences, so it ties in with the patient-as-customer rhetoric (in fact before this thread I thought the site was some government-sponsored prelude to marketised GP consortia).

We are sold the myth that this kind of simple aggregation of individual glimpses of a service is empowering of individuals (and by extension that we are more empowered as customers than as citizens). It isn't. What's empowering is an accountable central resource that asserts, evolves, monitors and reports professional standards based on objective criteria.

twotesttickles - "It's like asking an 18-25 holiday rep to organise a Saga holiday"

Yes, perfectly put.

Q. Does MN really need to 'partner' with some other website(s) doing "reviews", whether that be of health care, schools, or whatever ?

A. If you plan to do so in future, please MNHQ, query the membership before you start negotiations.

Oh, and it would be interesting to know whether you approached iWGC or vice versa ?
cos I'm a nosy bugger and would put money on iWGC asking MNHQ

It would only work if every single patient posted an opinion - and they won't. People post reviews on Amazon when they either love the book are mates with the author or hate it because there were two typos in the first chapter and that ruined the entire thing for them. They rarely post three star reviews saying that the book adequately filled up the four nights they hoped it would, and while it didn't set their world on fire, it was enjoyable and competently delivered nonetheless. No one's going to post 'my GP is fine, thanks'.

It's hardly fair on doctors with no true right of reply, and I'm not sure how helpful it really is when few people have much choice over their GP for geographical reasons.

I'm surprised MN would want to be involved, really.