Should we trust ratings?

NHS is making hospitals and doctors publish success rates

BUT – is this really helpful?  It hasn’t stopped appalling incidents like Mid-Staffs so why should we trust ratings on a website?

Image result for nhs humour

Get on the wrong side of an over-worked, tired nurse, and you can end up with brusque, uncaring attention that gives you a bad impression of the hospital.  Or, you could be feeling lost, and a nurse offers to get you a cup of tea.  The first nurse might be doing a magnificent job, and is covering for two colleagues who haven’t turned up for work, yet, the nurse that gets you a cup of tea might be over-looking all the signs you need attention, but her act of kindness makes you her friend for life. When you get home you write a bad/good comment on the hospital’s website to tell others about your experience.

So when you read comments about a hospital – read them all to get a feel if they are genuine, and also if they are just one adverse comment, or is there a common theme.  Read ‘between the lines’, we British are very good at this, masking adverse comment so it seems simple, but actually is giving out signals that all is not well.  But see if you relate to the good comments, and think if that is the outcome you are looking for.

In the ‘good old days’ your GP visited you in hospital, had time to listen, and formed their own opinion of a hospital’s care. This meant when they sent you off for an op. they knew which hospitals were efficient and caring, and which were not to be recommended.  Today, your GP won’t have time to visit you in hospital, and when they see you afterwards, whatever you say about your treatment, if their CCG has a contract with a certain hospital, that’s where they will refer patients – unless you put your foot down.

My case

Side effects of cancer drugs affected my heart, which sank when the surgeon whom I was seeing told me I needed an op. and be prepared for a seven-hour procedure.

At home I Googled his name and rating – then stopped.  It suddenly occurred to me that he was a surgeon at a genuinely world-famous hospital;  he would get patients whose last chance was a referral to him, so he would be operating on people who were at the end of the line, not those in for a simple procedure. Hence his ratings would probably be worse than a junior surgeon as he would get the complicated cases with a poor prognosis.

So if I trusted the Oncologist who had referred me I should go by his opinion – he should know.

Then, I was reassured when my Polio professor phoned me to wish me luck, and said “you’ve got a good man there”.  Apparently the heart surgeon had phoned the Professor to ask him about potential complications that might arise due to polio – and  the Professor wanted to tell me that I was in very, very good hands.

And I was.  

Read what a doctor’s blog says

Skeptical Scalpel is an American medical blogger, and this appeared in MD of 

If you are a patient looking for help when trying to find the right doctor, you probably think checking out online reviews would be a good thing to do.

This study should give you pause.

This paper looked at risk-adjusted mortality rates for cardiac surgeons in five states (California, New York, New Jersey, Pennsylvania, and Massachusetts) that have published these data. Of the 614 surgeons whose information was public, 96% were rated on one or more of the well-known rating websites.

The average risk-adjusted mortality rate for all the surgeons was 1.68% with a range of 0% to more than 16%. The median rating for all surgeons was 4.4 on a scale of 1-5, and the median number of reviews per surgeon was 4. That’s right, 4.

The authors found that the ratings don’t correlate with mortality rates. Some surgeons with the highest risk-adjusted mortality rates had ratings of 5.

The authors understated conclusion was: “Patients using online rating websites to guide their choice of physician should recognize that these ratings may not reflect actual quality of care as defined by accepted metrics.”

“Skeptical Scalpel” is a surgeon who blogs at his self-titled site, Skeptical Scalpel. This post appeared on Physicians Weekly.

What about you? 

Having an operation is always scary;  but if you find any comments on your surgeon, read the good ones and realise that people are quick to condemn, but slow to praise.  The statistics have to include people with good and bad prognosises, so should be taken with a pinch of the proverbial salt.  If the nurses have confidence in the surgeon – that is a good indicator.

Chocolate cake

And any surgeon has a big team behind them – I always take in a cake or home-made goodies specially for the team, and give it to the surgeon’s secretary before any op.  Last time I was woken up in Intensive Care by a junior doctor saying “we aren’t sending you back to your room – we are sending you to the kitchen so you can cook more for us”.

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