Online doctor search websites: risks for associated doctors.

Online doctor search websites offers the doctor good online visibility and availability, just like other streams; are there any risks associated with these kind of associations for doctors? I think risks are real and multiple.

I was looking for a dermatologist in the city, and i thought of giving a popular Online doctor search website   a trail. I typed initial alphabets of the word “dermatology”, it showed the list of 30 dermatologists in the city. In spite of the living in the city for 15 years, i could not identify most of them.

Most of the information was expected from Online doctor search website like fee, location, schedule and profile of the listed doctors.  There was enough information available online to actually decide who should be consulted. It has details of ones qualifications, affiliation of present and past and of course, the patient’s reviews. Plus it also had the assurance that if i am not been satisfies by the experience, i can at least write a negative review.

But there were some facts which actually drew my attention. The first 10 dermatologists had almost similar qualification (10 yes post MD) , fee ( 400-600 INR) and reviewer’s ratings (90-100%) and exactly same profile as there was no options of customization of profile for the doctor .

Online doctor search websites: Stay close and be cheap 

Clinical practice has always been different from the online sales of the movie tickets. It’s never actually about the number, though  a good practice is always reflected in patients count. Patient comes to you with a medical issue, often in distress. You establish an emotional rapport and trust with him, and treat him.

A satisfied patient shares that emotional connection and trust with other people which help a doctor to build the reputation in the community.  New patients coming to him are often refereed by older patients.

He/she is already primed about the doctor’s capabilities and knows what to expect. Slowly but steadily doctor build a follower ship of these satisfied patients which maintains a steady flow of new patients and is called a practice.

These Online doctor search websites reduces a doctor to a commodity, presented in a grid fashion, where all are more or less same and meant to be chosen on who is cheaper and conveniently available. Patient has to give star rating about how he felt about the experience. Patient can have hundred reasons why he/she gave a particular review or star rating and the next user has hundred different interpretations of the same review and rating.

There is no room for standing out of the lot, and if you want yourself to be featured ahead of others, than you pay for it. Practice is all about establishing your distinct identity among your colleagues with a separate patient base. You do not compete with your colleagues; you complement them in areas of weakness.

Online doctor search websites are designed so that patients develop loyalty with the site and a long term patient doctor relation could not be established.  If the doctor’s clinic is at a distance, select closer one. If time is not convenient, select some one more convenient to you. If you are not willing to move out, get an online consultation. You cannot contact with the doctor directly, by any means.

Also read:

Must know facts for online doctor search.

Medical Tourism : Trends, reasons, and a lesson.

Online doctor search websites :Patient inflow

Very design is such that is redistribute the users among the service provider. So if there are 1000 dermatology patients in a city with   30 registered dermatologists, site will ensure a distribution of these patients among the available doctors, is a way which is cost effective to the users. And how will the service providers compete with each other to increase the patient inflow.

You are available for longer hours and cheaper rates. Those who doubt it can have a lesson from recent OLA and UBER drivers’ strike. People initially joined these companies because they can get customers easily, but soon the number of drivers associated with the network sky rocketed without an associated increase in the number of customers. It forces the company to frame the policies so as equability distribute customers among the associated drives, significantly bringing down the monthly earning, making it non-viable option for some.

Patient’s personal and health related data 

As of now there were no clear cut guidelines. With drafting of Digital Information Security in Health Care Act.(DISHA), government has defined the policies clearly. It says that Protected Health Information (PHI) includes individually identifiable information which in-turn includes ‘sensitive personal data or information’ (SPI).

The new guidelines state that Protected Health Information (PHI) is owned by the patients and it the duty of the doctor to protect and secure the stored health information on patient’s behalf. Individually identifiable information not only includes name, contact number and Adhar but also the voice recordings of communication between doctor and patient that are non-clinical in nature. The  policies of every doctor search and appointment site clearly state that they are not a party in the doctor-patients relations , which leaves doctor squarely responsible to every contact or communication that happen  between doctor and  patients.

Online doctor search websites :Medico-legal responsibilities

There are no legal agreement between Online doctor search websites and doctor regarding the distribution/sharing of the duties/role and information disclosure policies. Online doctor search websites do not take the responsibilities regarding verification of patient identity and obviously take no measures to ensure that.

Some clearly state that they are not responsible if the user provided the incorrect information regarding personal identity. This put the doctor at serious long term medical-legal risks. Most of the websites have the stated policy of sharing patients contact details to third parties, (health information providers, drug supplying companies, investigations labs, taxi companies and so on) or have sister concerns engaged in these business.

Some of the companies encourage doctors to give online consultations on phone, mail, whatapp or similar applications. New regulations clearly state the doctor’s responsibility of ensuring privacy and data protection of patients consulted as these website are clear that they are not a party in doctor – patient contract you are entering in, with the patients.

Online doctor search websites : What happens in developed countries?

This concept of Online doctor search websites, is been there in US and there are few popular websites as well ( zocdoc). HIPPA (1996) clearly define a set of national standards for the protection of health information in US. All the site providing online doctor search and appointment are supposed to be HIPPA compliant. A lack of similar regulation in India could be attributed to proliferation such websites in India, which provide single stop solution for getting everything, from consultation with a doctor to ordering medication and gym membership, and from a single window. A similar lack of awareness among doctors could be a reason for doctors joining them.

One does not need to be a lawyer to negotiate through these offers. The important of being aware of once professional responsibilities cannot be emphasized more. There are two simple rules which can save anyone from landing in any of these risky associations.

1. Never associate with any online site without diligently reading and understanding the privacy policy and terms and conditions of the site. Later can easily be found on the header or footer section of the site.
2. Be aware of you responsibilities for patient’s privacy and protection of health information. Complete information is available at  information at the website of ministry of health family welfare, govt of India.