From Sue-Happy to Review-Happy

Remember the term "sue-happy"? -- as in, someone who sues anyone and everything for the slightest slight. I thought this was a term coined in the 1980s, but it was much earlier- it appeared in a 1951 issue of the Quanah Tribune-Chief newspaper (Texas, 'merica, ya'll).

Our sue-happy culture is alive and well in the 2020s-- causing a defensive strategy of restrictions, disclaimers, and guardrails, so that we, in our absentmindedness, don't hurt ourselves and speed dial the attorney.

Insurance has capitalized on this culture-- my malpractice insurance is over $40,000/year- and that's considered low nationally for my field- in some states, which don't have caps on damage awards, I might pay $200,000 (about half your yearly income). Lucky me-- my specialty always makes the top-5 "Most Likely To Get Sued" list- estimates say close to 80% of ENTs have been sued at least once. Ortho is the worst tho-- one suit every 3.5 years. Yikes.

The reality of malpractice claims: most get settled because it's cheaper for the malpractice company, despite the fact that doctors "win" 80% of malpractice cases at trial.

In most malpractice cases, everything was done right, but the outcome was bad.

The doctor can refuse to settle, but, if the doctor loses at trial, any monetary damages above the doctor's malpractice limits are taken directly out of the doctor's personal checking account. When faced with the prospect of losing your house, your practice, bankruptcy, etc versus the black eye of a settlement, most doctors will agree to a settlement even when they did nothing wrong.

It's interesting to me, in a country, based on freedom, that our freedom to sue diminishes our freedom to live (psst, by the way, there aren't signs next to cliffs in Europe saying you'll die if you fall- they just figure you know this already).

From suing to reviewing...

Our current culture has become "review-happy".

We LOVE to read reviews before we do anything-- eat, read, watch, stay, shop, etc. The popularity of social media demonstrates our societal desire to put it all out there- for a like...or a dislike. Don't get me wrong, I love reading reviews- as my wife and kids will attest (me commenting we should watch this or that solely based on the Tomato Meter)- but our review-happy culture has gotten a bit out of hand. Fewer love to write reviews, but this is getting common too-- and it's pretty much a "one-star/five-star world" out there.

As customers became accustomed to reviewing everything, I suppose it was only natural that patients, as "health care consumers" (I hate this term), would rate their doctors.

HealthGrades, in 1998, was the first to provide a platform, but many followed, including generalized business-centric platforms such as Google and Yelp.

To date, there is no doctor rating platform that factually ranks doctors' treatment quality and outcomes based on any raw data or quantitative metrics.

Doctor reviews are based on patients liking or disliking the doctor's personality/front office/billing practices and having a decent (usually short-term) treatment outcome based on their lay-knowledge.

I rate my surgical results and quality based on validated quality of life measures (such as the NOSE, SNOT22, etc) but this is voluntary and not posted on any website- we have thousands of data sets. I do this for myself to determine how well I'm doing- to hone my craft. Medical insurance companies seem to be unaware this data does/could exist- otherwise they'd be smart to rate surgeons based on similar metrics and preferentially contract with the higher quality surgeons or give the higher quality ones a bonus!

But Yes, you can now rate your pancake from Storm Castle Café 5 Tai Ln, Bozeman, MT 59715 (4.7 Stars, 960 reviews) and your rhinoplasty from Bridger ENT 1648 Ellis Street Suite 301, Bozeman, MT 59715 (4.6 Stars, 270 reviews) without ever leaving the Google Review page.

Dang, I thought my medical care was better than Storm Castle...although Storm Castle is pretty awesome (just sayin') and usually rated top 5 in TripAdvisor...haha.

My point...doctors don't serve up pancakes- we serve up healing. We swore an oath (we actually do this-- but the original words of the oath are pretty interesting) to the patient-- to hold ourselves to a higher standard than the common person, to be altruistic and self-sacrificing to a fault, to serve the "health care consumer" and to be uncomfortable and ashamed when a patient asks how much something costs (as if, we, doctors, have any personal control over this).

So, it hurts us, deeply and personally, when someone says "the doctor was 45 minutes late for my appointment and he seemed to think that was ok because he is a DOCTOR."

Yes, I will fully admit (and thoroughly apologize) I run behind sometimes-- but the reason I run behind (and did this day) is because I give each patient the care they deserve-- I wasn't behind because I was drinking espresso and counting my gold coins. Believe me, I've never heard a patient say "Oh, I just noticed my 15 minutes is up- you don't have time to talk about the rest of my problems and find a solution, so I'd love to take time off work again to finish this consultation."

It's really no wonder you're hearing more about doctor burn out these days...

Burnout recipe: 3 parts altruism + 1 part 1-Star Reviews.

You simply can't reduce the complexities of medical care down to the same level as your dinner at Dave's Sushi.

As much as I try not to, I read my reviews (often)- however, after being reviewed hundreds and hundreds of times, I'm getting better at trying to learn and grow from each one (positive or negative)-- I'm starting to see these reviews as opportunities for personal growth-- to help me make a better "pancake". Tho I always have to re-read my testimonials after getting depressed by a 1-Star jab.

Personally, I'd love to see us get back to the days of the good 'ole handwritten letter-- believe me, the negative ones hit just as hard, or harder, than a one-star mic drop.