Doctor rating portal

As a physician rating portals are websites referred that users give the possibility to doctors and other members of the healthcare profession to evaluate. Due to the generally lacking professional competence of the patients, this is not about the objective assessment of medical services and professional quality, but about the subjective evaluation of certain practice and personal characteristics, such as friendliness, availability, equipment, organization, communication, focus of activity and many more Criteria. The scope of the professional groups that can be assessed can vary from provider to provider. Most portals use a school grading system (from grade 1 = very good to grade 6 = unsatisfactory) or award stars (from zero stars = unsatisfactory to five stars = very good).

Users of a portal can rate their respective doctor, dentist or psychological psychotherapist after a visit to the practice , if they are in the database of the portal. For this, it is usually, but not with all portals, necessary to log in under a registered user name, which makes an anonymous evaluation more difficult. Nonetheless, the right to freedom of expression ( Article 5, Paragraph 1 of the Basic Law) also applies within doctor rating portals. According to this, doctors have to put up with an evaluation by patients, as long as it is neither defamatory nor false and does not represent an unproven assertion of fact .

Despite the high number of visitors, doctor review portals are generally criticized for their lack of relevance due to the insufficient number of reviews, insufficient protection against manipulation and abuse, and the sometimes difficult differentiation between patient opinions and paid advertising entries.

history

Portals

The portal checkthedoc.de , based in Munich, went online in 2001 as probably the first German doctor evaluation portal , but is now out of service. Helpster.de followed in 2005 . In 2007 a number of other portals went online. In 2008, a health insurance company (Securvita) launched a doctor evaluation portal with healthpool.de for the first time , but it never went online beyond the test phase. In May 2011, the AOK Federal Association launched its own portal, the doctor's navigator, which is still in the development phase. Doctors can initially only be assessed by all those insured with AOK, BARMER GEK and Techniker Krankenkasse. The Doxter, which was taken over by Doctena in 2016, is primarily for online bookings of doctor's appointments and only allows reviews after confirmed appointments in order to increase their reliability.

Evaluation pools and summary of the evaluations of several portals

There are also offers that summarize doctor reviews from several portals. In 2008, based on a study, the Health Foundation invited all portals to collaborate that had quality standards it had set. Since then, nine doctor rating portals have been merging their respective contents for doctor recommendation. The foundation also uses this data to create the patient satisfaction indicator in the doctor evaluation portal it operates itself. A search engine that summarizes the search results from some portals and displays them on one page, but with links to the respective portals, is offered at aerztebektiven.com .

Austria

There are also doctor evaluation portals in Austria: docfinder.at with an evaluation function and a proximity search, arztsuche24.at with an integrated search for additional offers and dentalace.at with a secure evaluation function and an online appointment booking option.

Switzerland

Medicosearch went online in Switzerland in 2008 . What is new about Medicosearch is that, in cooperation with doctors, quality groups have been defined to ensure that published doctor reviews meet the required quality criteria. Since 2015 there is another portal called DocApp, Online Doctor Appointment.

Health insurance companies and doctor review portals

Health insurance companies as public institutions are not allowed to operate a doctor evaluation portal themselves. The right to freedom of expression only applies to natural persons. Health insurance companies need a partner for this. Since November 2009, the Deutsche BKK has been the first health insurance company in Germany to offer a doctor search with reviews on its website. For this purpose, she has integrated the doctor information provided by the Health Foundation . The AOK Federal Association realizes the doctor's navigator in cooperation with the White List of the Bertelsmann Foundation and the Barmer GEK. The doctor's navigator was originally planned for autumn 2010. After a pilot phase in Berlin, Hamburg and Thuringia, the portal was launched in May 2011. The Techniker Krankenkasse has also been involved in the project since February 24, 2012. In addition, it has been possible to assess dentists (using a specially developed questionnaire) since then.

acceptance

In 2011, a representative survey conducted by the Gesellschaft für Konsumforschung (GfK) on behalf of the Jameda doctor rating portal among 1,130 private Internet users aged 14 and over showed that 22.6 percent of German Internet users use doctor recommendation portals to help them choose the right doctor. Around 66 percent of all those questioned rely primarily on recommendations from friends and acquaintances when choosing a doctor.

Content of the portals

reviews

The number of reviews varies greatly depending on the provider. In a random sample from the Health Foundation in 2008, the official information provided by the providers did not match the amount found. According to the official information, several doctors have come to an assessment so far. However, there is only a direct benefit for patients when several evaluations can be found for individual doctors. So far, this has only been the case in isolated cases.

The various portals differ in terms of the scope of the evaluations, which range from controversial one-click votes to detailed questionnaires. The portals yourFirstmedicus.de and the doctor information of the Stiftung Gesundheit offer not only patient reviews but also doctor-doctor recommendations. So doctors can recommend other doctors. For the portal bettereaerzte.de, reviews can only be submitted in the practice itself.

The quality of many doctor evaluation portals (usefulness for the consumer, transparency of the evaluation procedure, independence from financial interests) is increasingly being critically questioned. The German Medical Association and the National Association of Statutory Health Insurance Physicians have published a checklist for the quality assessment of such portals to provide guidance to users, portal operators and doctors, and have the Medical Center for Quality in Medicine assess existing portals.

Data

Most review portals have extensive data sets in which the names and addresses of doctors in Germany are listed. A few offer doctors the option of deleting their entries from the lists at their request (for example topmedic.de). That is, if a doctor doesn't want to be assessed, neither will he. Other portals give users the opportunity to create entries for medical practices. However, this harbors the risk of duplicate or incorrect entries - for example due to typing errors.

Health portals

Some portals not only offer the opportunity to rate doctors or clinics, but also editorial content on health topics. In the narrower sense, they are therefore not to be understood as doctor evaluation portals, but as health portals. For example, these are netdoktor.de, imedo.de, medfuehrer.de, qimeda.de, sanego.de or yourFirstmedicus.de.

safety

Most doctor review portals have technical security controls such as word filters and plausibility checks that protect against misuse and are supposed to sort out insults immediately. A few portals also allow free texts that justify an evaluation to be editorially checked before they are activated. Others do not even offer free text input. Still other portals do not publish free text entries on the Internet, but only send them by email to the doctor for personal information. Doctors can also comment on their survey results.

Others

Some general rating portals also offer their users the option of rating doctors and other medical service providers. An example of this is Yelp ; formerly Qype .

Quality of the rating portals

The Medical Center for Quality in Medicine (ÄZQ) has revised its catalog of requirements for doctor evaluation portals and carried out a second clearing process in 2012. The basis of the current assessment is the criteria catalog "Good Practice Assessment Portals", which appeared in the second edition in 2011: A group of experts, moderated by the ÄZQ, formulated 42 quality criteria for doctor assessment portals. The experts take into account legal requirements, data protection issues, transparency, protection against misuse and user-friendliness. Some of the reviews are publicly accessible.

Elsewhere, criticism is expressed that the interest in an active evaluation of services by the patients is very low and therefore not relevant. In addition, advertising and content are often not clearly separated, and the possibilities for manipulating information have not been sufficiently eliminated. The business models of private portal operators, in particular, often include the provision of paid advertising space for practice owners for self-marketing and self-presentation with reference to the possibility of increasing the private patient quota as well as for banners and advertisements for industrial customers. So they would primarily be an advertising portal .

Legal position

The review portals were initially very controversial. Doctors didn't want to be rated by patients. The discussion also focused on the risk of manipulating these portals. Doctors feared that not patients but other doctors could register under false names and give themselves top marks, whereas unloved or competing colleagues could give themselves bad marks. The medical associations are also skeptical to negative about the portals.

Since the right to freedom of expression is secured by the Basic Law ( Article 5, Paragraph 1 of the Basic Law), doctor rating portals are also protected with regard to the expression of opinion about members of the health professions. So also the OLG Frankfurt. The court emphasizes, however, “that an expression of opinion is characterized by subjectivity and elements of the opinion. Users of an evaluation platform are therefore aware that the evaluations do not meet scientific standards ”. Entries, on the other hand, are illegal if they are defamatory ( defamatory criticism ) or untrue. Assertions of fact may have to withstand a legal examination, which may result in a cease and desist declaration that leads to a forced deletion of the entry. Review portals avoid this process risk by immediately removing entries that contain factual claims themselves, or by preventing the possibility of free text input from the outset. In the latter case, the evaluator only has the option of clicking on predefined opinion criteria. The current case law is based on the judgment of the Federal Court of Justice. According to this, a forum operator has to remove corresponding entries if he is made aware of them. It does not matter whether the person who uttered the insults is known or not. A legal claim is not only valid against the offending or factual person, but also against the forum operator if he does not remove the entries.

Expression of opinion:
I felt I was being treated wrongly.

Assertion of Fact example:
I was treated wrongly.

Ultimately, however, both formulations have no informative value, since according to scientific criteria the patient may actually have been treated correctly, but in the first case only in the opinion of the patient, in the second case in accordance with the patient's conviction. According to scientific knowledge, treatment may also have been wrong, but at the time of his doctor's assessment the patient had the feeling that he had been treated correctly.

Anyone who makes a defiant factual assertion must be able to prove it. The burden of proof is not on the person who wants to enforce the injunction , but on the person who made the claim. Because defamation gets to § 186 , Criminal Code offense one who spreads a ehrrührige fact if it is not proven true. So it may be that the fact is indeed true, but the disseminator cannot prove it. It doesn't help the perpetrator that he is convinced of the truth. The same applies to the criminal offense of defamation according to § 187 StGB.

In a judgment of September 20, 2010, the Hamburg Regional Court decided that doctors may be listed in an evaluation portal even against their will. The prerequisite is that the address data is already publicly accessible.

In the United States, Medical Justice strives to use contracts to prevent patients from receiving online reviews from doctors.

literature

Mario Martini , a patient inspection for doctors? Evaluation portals as an innovative control instrument for health law, DÖV 2010, pp. 573-584; furthermore, doctors on the test stand, in: Hill / Schliesky (ed.), Innovations im und durch Recht, 2010, pp. 153–188.