Daniel Strech1. 1. Institut für Geschichte, Ethik & Philosophie der Medizin, Medizinische Hochschule Hannover (MHH), Carl-Neuberg-Str. 1, 30625 Hannover. strech.daniel@mh-hannover.de
Abstract
BACKGROUND: Hardly any academic research has been conducted on physician rating sites (PRS) with regard to their medical and ethical implications. In the public media, however, representatives of health care providers and payers have been involved in a controversial debate on the, at least, possible implications and practical consequences resulting from PRS. OBJECTIVES AND METHODS: The present article provides a conclusive explanation of why PRS can take on a significant role in future health care. Furthermore, using a framework of ethical principles, ethical and medical implications that can be related to PRS are systematically presented. RESULTS: Considering the so far rapid spread of Web 2.0 services, it seems plausible to assume that PRS will become a highly used source of information on selecting a physician. There are good reasons to believe that PRS may have a positive impact on health outcomes of physician-seekers as well as on the promotion of health literacy and equality of opportunity. However, considering the lack of evidence for these assumptions, the possibility of an opposite development should not be ruled out. The potential of damage for physician-seekers, for example, through misinformation, and for evaluated doctors, for example, caused by defamation, requires adequate prevention. On the other hand, preventive measures should not restrict the attempts at optimising transparency of medical practice too strongly. DISCUSSION: Further specification of the ethical principles outlined in the present article will significantly influence the upcoming decisions on the development and regulation (certification) of PRS. This raises complex normative considerations, the legitimacy of which can be enhanced by, among other things, adequate transparency, justification, participation and conflict of interest policies.
BACKGROUND: Hardly any academic research has been conducted on physician rating sites (PRS) with regard to their medical and ethical implications. In the public media, however, representatives of health care providers and payers have been involved in a controversial debate on the, at least, possible implications and practical consequences resulting from PRS. OBJECTIVES AND METHODS: The present article provides a conclusive explanation of why PRS can take on a significant role in future health care. Furthermore, using a framework of ethical principles, ethical and medical implications that can be related to PRS are systematically presented. RESULTS: Considering the so far rapid spread of Web 2.0 services, it seems plausible to assume that PRS will become a highly used source of information on selecting a physician. There are good reasons to believe that PRS may have a positive impact on health outcomes of physician-seekers as well as on the promotion of health literacy and equality of opportunity. However, considering the lack of evidence for these assumptions, the possibility of an opposite development should not be ruled out. The potential of damage for physician-seekers, for example, through misinformation, and for evaluated doctors, for example, caused by defamation, requires adequate prevention. On the other hand, preventive measures should not restrict the attempts at optimising transparency of medical practice too strongly. DISCUSSION: Further specification of the ethical principles outlined in the present article will significantly influence the upcoming decisions on the development and regulation (certification) of PRS. This raises complex normative considerations, the legitimacy of which can be enhanced by, among other things, adequate transparency, justification, participation and conflict of interest policies.