The Problem

For most consumers, the healthcare industry offers a host of uncertainty.  The cost and duration of each visit are difficult to predict, and quality of care can be even more complicated to judge.  Not only that, but consumers don’t often know what treatment options are even available to them, leaving them to simply accept their doctor's preferred treatment method.  Consumers who want to learn more about their options usually need to find second opinions from another physician which can be a costly and extremely time consuming process.  Even if a consumer manages to successfully investigate all of his or her treatment options, determining the possible risks and benefits of each method is another matter entirely.

As consumers, we don't tolerate such an extreme lack of information in any other industry, and it certainly doesn't make sense to tolerate it in an industry that we rely on to help maintain our health.  This then leads to the question, what can be done to fix the problem?

User Based Review Sites  

There are currently two major groups on the web that are attempting to address this very issue.  The first is the growing number of user based healthcare review sites.  The major problem with user based review sites is that many of them allow users to post with complete anonymity.  Some of these sites are actually counterproductive because the reliability of information can't be accurately judged since the posts are anonymous.  One site www.angieslist.com, attempts to address this issue by only allowing posts from registered members.  Even though this does prevent people from maliciously attacking a doctor or hospital and creating a lower rating for them, it doesn't change the fact that registered and unregistered users are subject to the same level of uncertainty and lack of knowledge discussed above. 

Another issue is HIPAA prevents doctors from participating in review sites, which essentially ensures that each site will be biased.  If bias is guaranteed by default, and most consumers aren't fully informed about the majority of healthcare issues, why trust the reviews and opinions found on user based review sites to begin with, regardless of if they have the best intentions?  Though sites like Angie's List don't provide the most reliable resource for consumers, they are valuable because their increased popularity demonstrates the growing demand for reliable healthcare ratings and information.  (To learn more about user based review sites and their impact on the medical community read or listen to an NPR broadcast on the issue here)

Research Based Review Sites

This leads to the second option, research based reviews and ratings.  There are currently a number of sites on the web that rate hospitals and verify doctor certifications.  One of these sites is www.ConsumerReportsHealth.org, which offers some of the most comprehensive research based health ratings on the web.  Consumer Reports (CR) aims to provide unbiased ratings (no outside advertising or free samples are accepted) to the general public to help ensure consumer safety.  Founded in 1936, CR extensively researches products through a combination of laboratory testing and consumer surveys to determine a product's overall safety and quality.  In 2008, CR launched www.ConsumerReportsHealth.org, a branch of CR focused on rating doctors and hospitals, medical conditions and treatments, prescription drugs, and other health related issues. 

Currently, the site offers survey based ratings on hospitals, but individual doctors are not rated. One of the site's most useful tools is the rating system for various treatments.  Users can select a medical condition and then see ratings for the possible treatments.  Each treatment is judged on how well the benefits outweigh the harms and is assigned a score from very unlikely (no benefit or likely to be harmful) to very likely (benefits very likely outweigh harms).  While CR's research based approach to their ratings is a step in the right direction, there is much more to be done before consumers have access to all the necessary information to make informed decisions.  (Learn more about how Consumer Reports determines its health ratings here)

The Solution

In order to truly eliminate the extreme uncertainty associated with healthcare, sites like CR will need to expand their research to include an analysis of not just hospitals and treatments, but individual doctors, departments within the hospitals, and costs.  Ideally, consumers could visit one site and determine which treatment is most beneficial for their condition based on an analysis of risks and benefits as well as approximate costs, establish which hospital is best equipped to provide the desired treatment, and find out which doctor is qualified to administer the treatment effectively.  While there are many obstacles to establishing such a comprehensive rating system, it is in the best interest of the healthcare industry to overcome those obstacles because the alternative is that consumers will continue to go to unreliable user based review sites to get what little information they can.  Providing access to reliable, research based information will raise the quality of care by creating more informed consumers and ensure that doctors and hospitals receive more accurate representation on the web. 

Again, most of us won’t buy a house or a car without doing as much detailed research as possible, so why shouldn’t we do the same with our healthcare?  After all, if we haven't got our health, what do we have?