The idea of being able to review your primary care physician and leave a comment online is a little unnerving for me. I know for a fact that not everyone can like me, and many patients will just be put off by my approach no matter what I do. But you gotta be true to yourself, and you can’t please everyone all the time.

The problem is that these review sites attract the crazies. The borderline personalities. The guys who want to talk shit because we didn’t give them their pain meds. The narcissistic personality disorder folk. All sorts of dysfunction.

So it’s not surprising when you read a negative review for a doc you know is a great doc. Someone whom most of their patients love. At least they don’t let people just post anonymously any more. That was a disaster waiting to happen.

But seriously, if people can complain about their doc, I think docs should be able to complain about their patients (and their family members.) Oh, I know that the HIPAA regulations make this illegal, but we could easily make it pseudo-anonymous. Like take their name and birthday, and make an MD5 sum out of it. So you could search the database for bad actors, and it’ll give you their MD5 sum and a description of them.

As an example:

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45 yo male with end-stage liver disease, ethanol dependence, opioid dependence, who once decided to overdose on acetaminophen because his heroin dealer refused to give him heroin. He likes to “split”, hating some people for no good reason, liking other people for no good reason as well, and is highly entertained when he manages to get you and his nurse fighting with each other.

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68 yo female with metastatic colon cancer, severe aortic stenosis, congestive heart failure with an ejection fraction of 25%. Her daughter frequently brings her into the emergency department, stating that her mother is dehydrated. If you refuse to admit her, she will threaten to sue you, and then will proceed to verbally abuse you. She will also demand that you page her mother’s surgeon, who doesn’t have privileges at St. Elsewhere Medical Center. He will, unfortunately, always side with the patient’s daughter and has a tendency to undermine any reasonable plan you can come up with.

This would be a stop-gap measure until we actually deployed a universal electronic medical record system in this country, but I’m almost certain it would cut down on the amount of morphine we dispense.