The internet truly is a wondrous invention. It has evened the playing field with a wide swath of people now having access to information that used to be possessed in the hands of only the elite few not too long ago. However, as with most things, there can be downsides associated with any tool of progress. Yelp Yelp is a powerful social tool that allows individuals to share experiences, good or bad, so that the masses can glean useful tidbits on a particular establishment. Great Yelp reviews, especially from the so-called, “social influencers,” can drive a large amount of traffic to a restaurant for example. Scathing Yelp reviews can, conversely, have owners hearing crickets when their doors are open. I admit that I have had Yelp reviews influence my decision on where to eat many a time, especially if I am in an unfamiliar place. However, hijacking a line from Uncle Ben in Spiderman, “With great power comes great responsibility.” And unfortunately, this unchecked power wielded by everyday citizens can indeed tarnish the original noble intent. There are instances of business owners getting extorted with the threats of false negative reviews on Yelp. Other patrons have threatened restaurants with negative reviews if not seated promptly. “That’s great, Xrayvsn. But what does this have to do with medicine?” That is a fair question, indeed. I only have a two-word response: Press Ganey. For the uninitiated, Press Ganey is a company that has created a survey aimed toward patients so that they can rate their health care experience. Much like Yelp, patients can essentially grade their physicians for each encounter they have with the medical system. The premise behind this survey is to create transparency in a business that typically shield’s itself from a consumer’s prying eyes and holds the medical professionals accountable. The main issue at hand is that these patient survey scores have an impact on the reimbursement formulas that the payors use to compensate physicians. Have a low enough score for patient satisfaction, and your wallet will feel the impact as you will be getting less money for a patient encounter that someone who has a higher score would. Afraid a patient seeking pain medications would leave a scathing review if you do not cave in and prescribe them? No worries. Just prescribe what the patient wants, and you can be assured of a 5-star rating. And if you refuse? Then you could suffer the wrath of an angry patient. Doing what is right and justified in medicine may incur financial and reputation penalties for the physician if the patient feels he or she is being under-treated according to whatever online source they might have stumbled upon. And like the Yelp examples above, this may unwittingly create medical practices that do more harm than good. There is also the potential for survey bias. What do I mean? We have all seen vehicles in front of us with the “How’s My Driving? Call XXX-XXX-XXXX” sticker. Question: How many of us have called that number to report the driver is doing a good job? Now if that driver flips the bird at you while cutting you off in traffic would you be more inclined to call that number? I know I sure would. Patients who have received bad medical care, perceived or otherwise, are more likely to vent their frustrations on the survey while patients who have exemplary or even just standard care may forgo answering the survey altogether. [As an aside I would like to tell of the following experience that drives home this point: In my commute to work, after some recent construction work had been going on, I noticed that there happened to be a stretch of interstate where some pretty severe potholes had developed for a period of two to three miles. Even worse, these potholes would line up at the border between the fast and slow lanes so an unsuspecting driver who happens to change lanes would get a rude awakening. I called the department of transportation hotline, spoke with an actual person and voiced my concern. The very next day, I was amazed that every single pothole had been filled. I called the same hotline and spoke with a representative remarking what a fantastic job they have done and how quickly the turnaround was. Her response was, “Wow. We always get complaints. You are the first person I can remember that called to give praise.” Social media platforms In addition to patient satisfaction survey scores, today’s physicians have other issues to contend with that their older counterparts never had to deal with in the past. As social media platforms continue to gain dominance over the internet, a side effect that modern-day physicians face is more to do with the appearance of high-quality care rather than delivering high-quality care. Physicians who have embraced this social media movement have taken to Instagram, Facebook or Twitter to promote themselves. At the same time, potentially more experienced physicians who do not “play the social game” may fall by the wayside as potential patients choose their more celebrity counterparts. Would you rather be operated on by the famous Dr. Oz or someone who is not famous in the media? Patients automatically equating celebrity to mean the best may indeed be setting a bad precedent. It gives a new meaning to the term “socialized medicine.” Source
