April 28, 2009--Dr. Zagat

The first Zagat Guide was created by Tim and Nina Zagat in 1979 as a way to collect and correlate diners’ ratings of New York City restaurants. In the spirit of unfettered democracy, where the voice and votes of the people trump professional expertise, for this initial guide, the Zagats surveyed their friends.

It became so popular that as of 2005, Zagat guides covered 70 other cities, with reviews based on the input of hundreds of thousands. After that, in addition to rating restaurants, Zagat guides evaluate seemingly everything from hotels to nightlife and shopping to zoos, music, movies, theater, golf, and airlines. The guides are sold in book form, via software for personal digital devices and mobile phones, and by paid subscription on the Web. It's hard to avoid them.

And recently we learned that the ubiquitous Zagats will soon publish guides to their readers’ top-rated doctors. (See New York Times article linked below.)

To the doctors, who swear by these guides to discover the latest downtown hotspots, this is taking participatory democracy a step too far.

One doctor who agreed to speak on the record self-congratulatingly complained that the Zagats are “treating medical care provided by dedicated and caring physicians as if we are preparing a meal.” Another condescendingly opined, “Are patients the best judges of health care? They notoriously ignore their doctor’s advice to eat well and exercise. Often they quit taking their pills when they are feeling better. They usually don’t understand the technologies and skills needed for treatment.”

Putting aside for the moment the complaint of some that "ordinary" citizens lack the capacity to do something really important--like vote for a president--this moaning on the part of doctors sounds a bit disingenuous because I’ve never heard any of them complain about patients of theirs referring new patients to them. Even patients who might have stopped doubling up on the Lexapro they prescribed. This voice of the people, as long as it fills up their appointment book, is just fine.

And they don’t have to worry about the Zagats publishing physician reviews that are as pithy as the ones they print about restaurants. To quote Nina Zagat, there will be no, witty remarks about a “doctor’s icy hands” or how a “crowded waiting room made the examination a downer.”

It may reassure doctors that they won’t be treated like Robert De Niro’s Japanese restaurant Nobu where comments such as “very accommodating to Sushi-phobes” are common, but it doesn’t reassure me.

I do want to know about hand temperature. When Dr. K___ asks me to assume the position for my annual prostate exam I do not want his freezing fingers to make matters worse.

So, just as the restaurant guides give numerical ratings for Food, Décor, Service, and Cost, how about assigning ratings for doctors for Time Spent With Patient, Quality of Magazines in Waiting Room, Prescription Handwriting, of course Out-of-Pocket Cost, and, yes, Hand Temperature.