http://www.mondaq.com/unitedstates/x/147428/Appellate/CostBenefit+Analysis+Adopted+By+The+New+York+Supreme+Court+For+Determining+When+A+Nonparty+Must+Undertake+The+Burden+And+Expense+Of+Recovering+Deleted+ESI

Of course, as is said over and over, the antidote to bad speech is good speech; yes, current online doctor reviews are worse than useless, but they won’t go away. If anybody is interested in doing somemthing about the problem, instituting serious commentary by the majority of patients would go a lot further than playing whack-a-moron with the crazies.

I am not from the US, and flew all the way to a famewhore ENT Plastic Surgeon in Beverly Hills.They also gave me a pack of agreements to sign, which I could nt understant and his patient consultant care did not explain to me and she told me to hurry up and the papers are not so important. Now after the disappointment of the surgery and after being ripped off and after being exposed to malpractices I cannot inform other prospective patients to be aware?! They are not allowing me to share my experiences online…Going the the US (Beverly Hills) was the biggest mistake in my life. It is a fraud. Due to these agreements which I feel they are unfair I do not recommend anyone outside the US to fly for plastic surgery in the US. Be aware! and for those who have well establish plastic surgeons mainly Europe, think about it twice. They have these agreements which infringe upon your rights of speach. Furthermore, doctors can post good reviews online themselves and you would only see the good ones-as I did.

“In addition to quality reporting, Health Care Community Discussions also recommended cost reporting. At a Colorado Discussion, participants stated, “[P]ublic policy can create a data base to compare providers and their costs for basic services. In this database can be a listing of their filed complaints or some type of review (maybe similar to the Better Business Bureau) where consumers can know if they are seeing a quality provider or not (rather than relying on the insurance company to tell them who they get the best rates from). Providers would ultimately benefit because patients would migrate to those more efficient/better outcome providers.”

Good luck to Medical Justice, as Dave wrote earlier!

The Hipster cites an MSNBC poll that reaches a new nadir of unscientificness – we could use this as a quiz question for rookie survey design students:

Would you sign a contract that would prevent you from reviewing a doctor online?

86.9%: No way! If a doctor is bad, I’m going to spread the word however I can to warn other patients (597 votes)

8.7%: Definitely. I trust my doctor completely. Besides, if a physician is truly bad and patients need to be warned, there are better, more legitimate ways to complain about the care provided (60 votes)

4.4%: I’m not sure (30 votes)

Again, that’s a model of an unscientific survey. But as I said, the whole idea looks like a comical attempt to hold back the tide. Why bother?

We are talking about apples and oranges. John’s “statistical data model” and the sites to which he (and this controversy) refers are not the dynamic information and support communities to which Dave and Gilles refer (i.e. ACOR lists).

ACOR is a virtual 24/7 live action model of open sourcing or “crowd sourcing” a problem. Members’ knowledge builds exponentially, is archived, refreshed, repeated and constantly built upon. As information sources (not a rating source per se), these list have come to include top docs or top “niche” experts to whom we have near instant access via the Internet, with whom we have built up relationships of trust over the years.

It took about ten weeks from the first “whoops!” surgery to final diagnosis and treatment plan on my daughter’s case in 2003. I stopped thinking I was crazy when someone on the LIST informed me that sarcomas were often misdiagnosed, that the flipping of diagnoses from benign to malignant to some other cancer or maybe not was a common scenario. This was something the ped. oncologists could not do for fear of not sounding authoritative.

For newbies, we are now down to about 2 hours to find the right facility/doc, often with direct contacts with the social workers or the onco. nurses or the docs themselves. This is virtually unimaginable to Civilians. When the troops get tired, or someone dies, the knowledge gets carried on by a new wave of advocates.

As Dave and Gilles point out, this is not a statistical model nor is it an evaluative or ratings system (although we get beyond the chaff pretty quickly without mentioning names) nor is it “consulting online sources” like WebMD or PubMEd to get information. It is unique: participatory medicine. Believe me, it is VERY HARD to describe to people who are fighting their way through a cancer diagnosis without an e-community. Sitting by the phone, awaiting a phone call from the doctor’s office about how to proceed.

The best analogy would be the Verizon network cell phone ad (the guy stuck in the swamp with the Mafia, who looks outgunned until his network appears) or a floating craps game.

Evaluation of a physician is only a small part of the process. It is not perfect knowledge, it is human knowledge. We disagree, clarify, compare notes, check sources, add new sources. We also hook doctors up with new sources, sites and information.