Whitecoat is launching its new online platform, dubbed Australia’s ‘Trip Advisor of healthcare’, today, saying it empowers consumer by allowing them to locate, rate and compare doctors, dentists and allied health professionals in their area while at the same time giving health professionals increased opportunities to ‘connect’ with patients online.

Whitecoat was first launched in Australia in 2013 by health insurer nib, listing mostly dentists and physiotherapists from nib’s database, and the first New Zealand listings are also being provided from the local nib database. The Australian site in 2017 expanded to add GPs and specialists, plus two more insurers, and now has more than 90,000 health professionals who have ‘opted in’ and around 800,000 published reviews.

“We had a backlash in Australia and there are still remnants of that,” said Whitecoat CEO Matthew Donnellan. “But ultimately it comes down to – we review everything in everyday life – so why is it that healthcare considers themselves above being reviewed? And I can’t think of a good reason.”

Dr Richard Medlicott, medical director of the Royal New Zealand College of GPs, said he thought a lot of doctors would be anxious and nervous about the arrival of a rating platform. “But at the same time I think we need to be realistic that this is happening internationally – there have been ‘rate your MD’ sites overseas for years. The internet is a remarkably open place and this is happening to all kinds of businesses so we shouldn’t be surprised that it is happening to ours.”

Ian Powell, executive director of the Association of Salaried Medical Specialists (ASMS), said the rating website launch sets a “dubious precedent” with no guarantee of greater transparency or improved quality of care. He said it raised serious concerns about fairness if comments could be made without context for example a parent posting negative comments about a doctor who initiates child protect protection proceedings or on a doctor who performs abortions. Powell also had strong concerns about the site being backed by health insurance companies with their own vested interests.

Donnellan said patients aren’t allowed to do any clinical reviews – like claiming they were misdiagnosed – but they can say ‘the doctor was late’ or ‘the dentist was rude’. “But as has happened in Australia – where we have 800,000 published reviews – 93 per cent of reviews are positive. So the vast majority of people say ‘my doctor listens to me’, ‘my treatment was explained well to me and I can really recommend them’.”

New Zealand Medical Association chair Dr Kate Baddock said the new platform had the potential for some positive benefits but definitely had risks of some negatives for the medical profession.

She said while reviews were not supposed to be clinical it would be hard to know when a patient’s grumpy review might be due to them being unhappy with the doctor following best clinical practice. For example a patient with a severe head cold who leaves disgruntled because their request for antibiotics were turned down. “So even though it might have been a surgery in a great location and you may have been greeted very cheerily by friendly staff when you came through the door but – because you didn’t get what you want in your consultation – you may perceive it as a negative experience.”

Baddock also had concerns about the transparency of the moderation process and pointed out that New Zealand consumers could already quite easily search and find extensive  information about general practices in their area.

Dr David Crum, the chief executive of the New Zealand Dental Association said the most sensible way to select a dentist was to talk with family and friends and be referred to someone they already know and trust.

Powell also made the point that popularity and charm in a health professional does not automatically mean a higher standard of clinical practice or better outcomes of care. “For example, Dr Harold Shipman was loved by his patients!”

Donnellan said Whitecoat was first started it was considered they were trying to make health a popularity contest – but that is nonsensical and ridiculous,” said. “Initially we had a lot of organisations in Australia – the doctors and dentists – saying ‘don’t do it’ but over time as consumers spoke and they did their reviews and professionals saw they were getting valuable feedback and getting more bookings and patients. So more and more opted in.”

Medlicott said the College would be independently developing a resource for GPs if they are subject to what they see as a vexatious, unfair review.

“It is interesting you can be a doctor with great clinical skills and bedside manner but if something goes wrong on the day and the patient gets grumpy for some reason you may get a review that is problematic. But on the whole most reviews I’ve seen on rating sites are generally complimentary …we will just have to see how it goes,” said Medlicott. “Whitecoat does seem to have a reasonable moderation policy – so there is some opportunities for doctors to manage things to a certain extent.”

Dr Lance O’Sullivan said he was supportive of the platform as providing an easy way for people to compare healthcare providers in their local area and read reviews from other patients. “It provides a platform for feedback and keeps health professionals accountable,” said O’Sullivan

When Whitecoat expanded in 2017 to include two more health insurers, as well as adding GPs and specialist profiles it said it wanted to ultimately allow insurance consumers to compare doctor and surgeon clinical performances – a move criticised by the Australian Medical Association and not on the agenda here yet.

In the UK patients can go onto the NHS Choices website to search for consultantsand surgeons and view perfomance data on the number of procedures they have carried out and whether their 90-day patient mortality rate is within the expected range. A New Zealand Herald request for surgical safety records in 2016 led outgoing Ombudsman Ron Paterson to call on the Ministryto start publicly reporting patient death rates and other ‘outcome’ data of public hospital doctors or units by 2021.

Donnellan said in Australia insurance consumers are texted after payment inviting them to anonymously review their health professionals. But there was also a process for the general public to submit reviews that were subject to a moderation process and there were software algorithms to detect and deter consumers or health professionals ‘gaming’ the system.

Whitecoat was initially launched in Australia professionals were asked to ‘claim’ and activate their Whitecoat profile or ask to be removed. Donnellan said on start-up in Australia it had about 500 professionals take up their profiles and over four years – and with the addition of two more insurers – it had now had 92,000 health professionals who had ‘claimed’ and activated their profiles (out of 220,000 listings) and 800,000 published reviews.

Donnellan said it chose to use the nib databases for the site’s initial health professional listings rather than  ‘scrape’ the listings from public lists of registered New Zealand health professionals as it was aware that would have been a great way to antagonise people. He said nib would be contacting the listed professionals inviting them to check out and either ‘claim’ their profile or opt out “then they disappear”. Non-listed health professionals can also chose to opt in to the site and Donnellan said it was also in discussion with ACC and other health insurance providers.

Whitecoat hopes to have 10,000 physiotherapists, dentists, GPs, specialists and other allied health professionals on the platform by end of September and 25,000 by the end of June next year.

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