Does India need a “TripAdvisor” for healthcare?

Early last year, when I finally threw in the towel at my workplace quite a few well-meaning (and possibly alarmed) persons in my circle of family, friends and professional contacts began thinking of ways to keep me gainfully employed.

One such person was my other half. My husband is one of those creative geniuses who always has more ideas than either resources or people to execute them.  Still, that does not dissuade him from “ideating” at all and sundry.  One day, he looked at me vegetating on the sofa- quite happily, I might add – and snapped his fingers. “I know what you should do,” he said quite decisively. “Start a TripAdvisor for healthcare.”

From bon voyage to bonne sante

Now, TripAdvisor needs no introduction. It has become the go-to-resource for people across the travellers’ spectrum from overworked mommies to hard-nosed businessmen.  For the record, it’s a travel website that has created an extremely useful and consumer-friendly resource by getting users to write detailed reviews of their travel destinations – places to stay, visit, eat at and so on.  For instance, users rate hotels on various parameters such as hygiene, food and child-friendliness.  I’ve personally found this pretty awesome while planning travel with the family.

The logic of doing a TripAdvisor for healthcare is elegantly simple.  Our health is  clearly important, more important to us than stuff like how far we have to walk to get to the beach from the resort.  Yet our ability to select the best healthcare (doctor, hospital) for ourselves within a certain geography and budget is limited by a lack of information because of inadequate networks.

Just like hospitality, healthcare delivery too is growing rapidly in India with different players at different price points and of differing quality.  It’s impossible to unerringly chance upon persons with prior experience of a doctor or hospital, each time it’s needed.

Now imagine your network expanding to a community of users (patients, relatives) who will share their experiences of everything from the doctor to the hospital and the auxiliary staff and whether the hospital really accepts your cashless health insurance card.

The consumer knows

I can see some raised eyebrows.  How on earth are patients and caregivers, sometimes under great stress and emotionally overwrought, to judge something as complex and technical as healthcare?

Well, aren’t we already doing it? Think about how healthcare works in this country.  Your mother needs a hysterectomy.  Her family physician recommends a surgeon but the neighbour isn’t too happy with this personage – maybe (s)he wasn’t easily available post-op, or the poor woman came back with a hospital-acquired infection from the nursing home.  So mom calls your dad’s friend’s wife who just underwent a gynaecological procedure with a different surgeon.  This woman is all praise for her doctor, found the hospital clean and the staff competent. Geography and economics being comparable, chances are your mother goes to this doctor.

Ultimately, while it’s delivery is complex, healthcare from a consumer’s point of view is actually simple. One is either fine, or not. The doctor’s either clinically good, or not. The nurses either know (and do) their jobs, or don’t.  The hospital is either clean, or it isn’t. And frankly, if something is in fact, really good, shouldn’t the world know about that as well?

Patients know what’s important. What the heck, this country has doctors with terrible bedside manners who have a huge following simply because they are clinically outstanding.

How others do it

Still sceptical? Well consider what’s happening elsewhere.  In the UK, iwantgreatcare.org has been operating just such an initiative.  Its website has this to say :

  • iWantGreatCare lets patients leave meaningful feedback on their care, say thank you and help the next patient
  • It’s a service that is independent, secure and trusted by patients, doctors and hospitals
  • Feedback is provided on doctors, dentists, hospitals, GP practices, medicines, pharmacies and nursing homes to ensure problems get fixed

Now, I read about this last week thanks to Paul F Levy, a former CEO of a Boston hospital whom I follow on Twitter. Levy shares some very interesting and insightful thoughts about hospitals, medicines and healthcare on his blog runningahospital.blogspot.in.

This is what Levy had to say : “A group in the UK called iwantgreatcare.org has been running a consumer evaluation website about doctors and hospitals.  Analogous to TripAdvisor, people can post quantitative rankings as well as qualitative comments.  It covers 100% of the NHS hospitals and over 200,000 doctors.  All information is absolutely transparent to the public, the clinicians, and the hospitals.” You can read more of his post here.

It is also highly probable that a public ratings system will encourage doctors and hospitals to up their performance and figure out areas of improvement.

Like any other initiative, there will be hitches. One is of course the Indian culture of not being overtly-critical in public of figures of authority. While much can be said over the phone and one-to-one, people may baulk at writing it down even anonymously.  However, I’m beginning to believe that this is changing especially with the inroads made by social media that encourage users to speak their mind on everything.

Two, fraud. It is important that such an initiative not be used to settle personal vendettas or pull down the competition or even do puff pieces. Again, there are learnings on how to prevent fraud from other consumer evaluation websites. But this will be a continuous challenge.

Three, patient privacy.  How does the website verify if such-and-such patient underwent such-and-such procedure at a particular hospital as part of its fraud checks?

Four, what should the revenue model be? (Or should this be a non-profit/charitable initiative?)

TripAdvisor’s own experiences show these are not insurmountable problems. It reportedly has 75 million reviews on its system;  there are 32 million members with accounts that have contributed at least once on the site. And this, not for lack of criticism.

I personally don’t have the derring-do for this, whatever the husband may think.  But I am willing to bet there are some of you out there who do or know someone who does. Go for it.

Pic sourced from Google Images

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About Gauri Kamath

Pharma and healthcare blogger

8 thoughts on “Does India need a “TripAdvisor” for healthcare?

  1. Pingback: Does India need a TripAdvisor for healthcare? -- Apothecurry | STARTUPCENTRAL

  2. This is one of the best blog and in time. This is a must and necessary for a country like India with more and more people addicting to google. This will surely helps lot of them who are often confused with different opinions from different hospitals. and a way to go.

    Ensuring validation of the commenter and quality plays an important role for the success.

  3. One point to keep in mind is that what the consumers are rating here is the experience and not the actual effectiveness of health care. Most health related issues require complex decision making and inputs from various sources. In this regard places like UK the doctors follow standard guidelines and have well defined mechanisms for referrals. India on the other hand has a completely unregulated health care market without any national level guidelines. In absence of this relying on such a website(s) is likely to encourage health care which is not focussed on efficacy but on satisfying the whims of the patient.
    An example from the world of Oncology: One of the interesting “lies” that is spread in the market is that treatment of patients on Cobalt is inadequate. This is a lie that is mostly spread by private health care organizations so that people can be moved away from government hospitals. However evidence says otherwise and with a competent oncologist even a cobalt machine can deliver great health care. Unfortunately what happens is centers equipped with a single cobalt machine are invariably overloaded with poor patients and this results in the centre delivering adequate radiotherapy but at the cost of overcrowding and often a poor ambience. Ultimately cure rates are not much different betwen the fancy center and the government center. But a site like tripadvisor will ensure that the government center gets negative marks for a poor customer service and the fact that equivalent cure rates can be obtained there would be supressed.
    On the other hand if we have a standard of care which is applicable across the nation with detailed guidelines and evidence based medicine then such a website will be of immense help. Otherwise such sites will become mouthpieces of private health centers who have the resources and inclinate to “game” the review system.

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