STEVE INSKEEP, host:
Many people get recommendations from a doctor they find online at Web sites like findadoc.com or doctorscorecard.com. That Web site name suggests a way that consumers are changing their approach to doctors. They're using the Web to rate their physicians for the benefit of other patients.
Deirdre Kennedy reports from San Francisco.
DEIRDRE KENNEDY: Dr. Vail Reese is one of the most highly rated doctors on local San Francisco search engines.
Dr. VAIL REESE: I'm Dr. Reese.
Unidentified Woman: Hello. Nice to meet you.
Dr. REESE: Pleasure to meet you. So what brings you in today?
KENNEDY: As a dermatologist, Reese sees patients with the usual embarrassing skin disorders - athlete's foot, acne, scary moles. In his beautiful art deco offices, he gives every wart and blemish personal attention, peering at them through a large magnifying glass.
Dr. REESE: We'll talk about this mole, but it really should be fine.
KENNEDY: Reese says about half his new patients find him through sites like Yelp, a social networking site that lets users share their experiences about their doctors.
Dr. REESE: These review sites, they will blog and comment on everything in an office. So they'll talk about what the nurse said or did. They'll talk about the way the receptionist was on the phone. They'll talk about their interaction with the billing staff or service.
KENNEDY: The kind of patients who choose Dr. Reese this way are people like David Victor, a computer professional in his 20s.
Mr. DAVID VICTOR (Computer Professional): I was a little skeptical. I wasn't sure of how easy it would be to taint the system.
KENNEDY: There's no doubt that doctors can procure positive reviews from friends, relatives, or even patients. So Victor checked to make sure the reviewers had written about other doctors or topics and weren't just online to rave about Dr. Reese. Victor ended up giving Dr. Reese a try and writing a favorable review himself.
Mr. VICTOR: You know, my expectations were met and probably exceeded.
KENNEDY: Health insurance companies have been rating doctors for years on their performance, but consumers seem to prefer the opinion of their peers over a company that might have a financial interest. WellPoint, the nation's biggest insurer, is apparently paying attention. It recently teamed up with Zagat, famous for its restaurant and hotel guides, to provide a rating system for doctors based on consumer input.
Founder Nina Zagat.
Ms. NINA ZAGAT: And the separate categories are trust, communication, availability and environment.
KENNEDY: Zagat says the physician rating tool serves what she calls the soft part of the patient's choice.
Ms. ZAGAT: We were very careful not to include any criteria that we felt the individual consumer was not in a position to rate; for example, the technical abilities of a doctor.
KENNEDY: But while the touchy-feely part of the patient-doctor relationship is definitely important, choosing a doctor solely on superficial qualities can be a disaster, says Dr. Robert Wachter, author of "Internal Bleeding," a book about medical mistakes in America.
Dr. ROBERT WACHTER (Author, "Internal Bleeding: The Truth Behind America's Terrifying Epidemic of Medical Mistakes"): Spectacularly good doctors every now and then have patients who die. Terrible doctors most of the time have patients who do just fine. People are pretty resilient. So when you look at one experience and try to extrapolate from that - is this the person I want opening my chest up and fixing my heart? - scientifically it's not the way you would want to go.
KENNEDY: He says patient reviews are skewed because they're usually only written by people who either hate or love their doctors. He also mistrusts insurance company sites, which rate their own doctors because they tend to steer patients to the cheapest rather than the best physicians. But, he says, at least these sites can tell you how many procedures a doctor has done.
Dr. WACHTER: If all else is equal, I would rather see the doctor who's done this particular surgery that I need a hundred times as compared to the doctor who has done it three times. There is in medicine, like many things in life, a practice-makes-perfect kind of curve.
KENNEDY: Particularly with challenging medical conditions, says patient advocate Trisha Torrey. After being misdiagnosed with a rare, fatal lymphoma, she urges patients to search several sites to get the full picture of a doctor's background.
Ms. TRISHA TORREY (Every Patient's Advocate): Perhaps when they graduated from med school, whether or not they are board-certified in their specialty area, how long they've been in practice - that's all good information to have.
KENNEDY: But health care safety advocate Robert Wachter says what patients really need is an independent national database.
Dr. WACHTER: What patients can do collectively is put pressure on doctors, hospitals, the government and others to create a set of information to allow patients to make truly informed rational choices.
KENNEDY: Some states are working with insurance companies to help forge national rating standards, but it could be another few years before they're in place.
For NPR News, I'm Deirdre Kennedy in San Francisco.
INSKEEP: You can get the latest scientific findings on eye surgeries, food from cloned animals, and caffeine at npr.org/yourhealth.
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