Saturday, 2 August 2014

Chinese doctors not happy at rating lists made by patients

by Michael Woodhead
Are you on the Medical Honour Roll or the Black List?
That's the question being asked by doctors in Guangzhou over the websites and social media forums that categorise doctors in the city according to a 'red list' (Honour Roll) or black list. The widely circulated lists ask members of the public to rate doctors according to these criteria:

Black List: 
Attitude: cold and aloof
Orders a lot of tests, prescribes a lot of drugs 
Recommends lots of nutritional supplements

Red List
Good demenour, attentive
Willing to explain
Not an overprescriber

The lists of doctors at 15 of the city's hospitals have been circulated widely on forums such as Weibo and Weixin, but health authorities claim that they are subjective and un-scientific, and will lead to increased tension and disputes between doctors and patients. They are calling on Guangzhou residents not to circulate or contribute such misleading unofficial lists. They have noted that there are many insulting and coarse comments about the doctors on the Black List, but the doctors named have no right to reply or to correct the statements made about them.

The Black and Red lists also allow users to add their own experiences. One women who claimed to be a patient at a maternity hospital said the named doctor did not even let her finish speaking before writing a prescription and asking to see the next patient. Another said the doctor barely listened to her, ordered 1000 yuan of tests and when she said she didn't have the money to pay for them, simply threw the forms in the bin.

A common refrain on the doctor rating forum sites is that it is impossible to find a sympathetic doctor who is easy to see without a long waiting time or guangxi.

However, the deputy director of one of the city hospitals told reporters that these assessments of a doctor's capability were subjective, unverified and often taken out of context. He said the Red List and Black List did not reflect the clinical skills and experience of the doctors named on the lists. All senior doctors working at the city hospitals had to study for many years, pass many exams and were also evaluated by their peers before gaining promotion, he said. Doctors who were incompetent or who practised bad medicine were not tolerated within the public hospitals system, he said.

The hospital director said patients often got a false impression of doctors because their encounters were superficial and they often had to wait for a long time to see them, hence they had a sense of grievance. The comments did not reflect the pressure under which doctors work he said. Also, many of the comments were about the 'service attitude' of the doctors, which did not reflect their medical skills, he said. He compared the 'doctor rating' sites to theatre reviewers - two people can see the same performance and one will hate it while another thinks it is good.

Another deputy director at a vascular hospitals said the lists were meaningless and some even had the same doctors on both red and black lists. Individual opinions varied, he said, and he used the saying "one man's meat is another man's poison" to show that some patients would find a doctor to be 'good' while others would find them to be 'bad'.

Health authorities recommended that consumers use the "Third Party" healthcare service  evaluation site. This invites feedback for healthcare consumers, but the information is checked and verified by independent professional before being added to the website. The Third Party site also follows up claims of problems such as overcharging and overservicing and will contact the patient and the service provider to provide feedback and improve the service, the health authorities said.

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