A growing number of websites in Switzerland can be used to give an opinion about services provided by a medical professional. And that is affecting the patient-physician relationship.
Choose, book and comment. Having grown up with TripAdvisor, Booking.com and Digitec, young people are used to doing everything online via their smartphone, instead of actually talking to someone. So why should medical care be any different? Symbolising this new habit, Medicosearch.ch saw its traffic double from July 2017 to July 2018 and now has over 600,000 users a year.
The website has information on more than 20,000 doctors and specialists in Switzerland. Patients can not only make an appointment online, but also rate the service and leave a comment after the appointment. Behind the scenes, retired doctors act as moderators and filter reviews.
The creation of healthcare rating sites at the end of the 2000s initially caused an uproar in Switzerland. The Federation of Swiss Physicians (FMH) took the case to the federal government, stating that they were formally against online comments. “In accordance with Article  28 of the Swiss Civil Code, hospitals and medical practices can file a complaint for an attack on character when their reputation is on the line,” the FMH’s spokesperson told the press. “They can even file criminal charges if it involves libel.” But the law is more effective at putting pressure on Swiss websites than on companies based in the United States, such as Facebook or Google. Even when hospitals and medical practices manage to have defamatory remarks removed from the websites of tech giants, these companies can be slow to act, and a medical professional’s e-reputation can be lastingly tarnished.
The FRC opted to publish a little guide for the informed patient called La Boussole du patient (The patient’s compass). The guide suggests questions patients could ask a general practitioner during the first appointment. “Patients have to form their own opinion, to see if there’s a connection. Our book helps build the patient’s trust to share needs, experiences, observations and concerns.” And nothing is better than recommendations from other healthcare professionals, or word of mouth among friends and family, Ms Muster says.
So what can be done when reviews are already all over the web and on less ethical sites? Dr Jeannot thinks that doctors should be aware of their online reputation.
“For example, they can create a website, release their publications, participate in press articles, etc.” He adds that it is not rare for patients to come to his practice after reading information about him on a search engine.
Large university hospitals in Switzerland monitor what is said about them and their staff online. They even hire communications experts to respond to dissatisfied users. For instance, Lausanne University Hospital (CHUV) encourages people who post negative reviews on Google to contact the Espace Patients&Proches (Patients & Loved Ones) service. “When a healthcare professional or department is singled out in a comment, the author is asked to contact us,” says one of the service’s mediators, Thierry Currat. He recalls a doctor who, after being criticised on Google, immediately went to see him. “He was outraged and hurt. And the patient felt betrayed and angry. They opted to meet, which helped each side understand what motivated the review.” The author ended up changing the remarks.
The mediator points out that a university hospital is different from a bad restaurant. “Patients can’t decide not to go back to CHUV. They have to be able to go back if they need to. To do that, trust must be re-established between physician and patient, and between institution and patient.” The Espace Patients&Proches service handled 544 cases in 2017, and far from the web.
– meeting a mediator (from the Espace Patients&Proches service at CHUV).
Created in 2009, medicosearch.ch really began to take off with the introduction of online appointments. “Automatically synced with the doctor or specialist’s calendar, the platform saves time and reduces errors,” says its Chairman and CEO, Beat Burger. Healthcare professionals set the game rules. Do they want to have a designated space for reviews? What information do they want to provide? After the appointment, patients can rate the service in a questionnaire.
“I had two abortions, but I didn’t feel judged,” is an example of a comment about a Vaud-based gynaecologist on AdopteUnEGynéco. Following the example of the “white lists” established by the Women’s Liberation Movement in the 1970s, the website was created to promote “compassionate gynaecological care”. At first, the women’s group collected questionnaires from people who wanted to share their opinion about the gynaecologists they saw for care. It then published an information profile for each specialist, including their approach and anonymous positive comments posted. However, practitioners are discouraged from promoting their services on the site and can ask not to appear on the list. As of August 2018, nearly two years since the website came online, 70 “safe” gynaecologists have been listed.