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The question: I recently found a new doctor on the recommendation of a good friend. I was curious so I googled his name and found that his ratings were quite variable with some negative feedback. My friend thinks this doctor is great, but I'm concerned given the reviews. Any suggestions on what this could mean and how to move forward?

The answer: It's natural to want to have some background information about a new doctor. If your friend feels this doctor is great, my suggestion would be to go in with confidence that this may be a good fit for you too.

Many do look to the Internet to find opinions on doctors, similar to choosing a movie or hotel based on online reviews. Rating sites are popular and offer the opportunity to anonymously post reviews of a physician's care.

Establishing a trusting relationship with your doctor, however, is different than choosing a hotel or movie, so you'll want to keep some points in mind.

First, it's important to realize that we can never fully understand the context that motivated the patient to post a review. Was a negative review related to patient frustration that they didn't feel heard or felt rushed? Did the doctor make an error? Was the patient upset because the doctor didn't prescribe a medication? Was the review based on a single appointment or on several visits? We are each unique in what we look for in a doctor, so it's important to consider if the complaint is something that would even be relevant to you. An individual doctor may receive both positive and negative reviews for the same practice-style.

Also, some rating sites focus on specific markers such as the quality of front staff, punctuality and communication skills. While these factors are important to consider, they don't offer a complete view of how well a doctor actually takes care of her practice. Such reviews may not offer information about how well a doctor is reaching disease-related targets, if they screen their patients appropriately and if they offer up-to-date and evidence-based care.

Another challenge with any review or rating site is that their anonymous nature may mean that people are not as accountable for their comments. Because patient confidentiality must be preserved, doctor-rating sites must remain anonymous, but it does highlight the need for caution when deciding whether to trust or not to trust a review.

It's easy to see how these sites came into existence and why they are increasingly popular as they offer a safe place for patients to voice their opinions about their health care. Despite doctors' efforts to provide patient-centered care, there still remains a power differential that makes it challenging for patients to openly discuss their concerns.

Ideally, when a conflict occurs, patients should be able to voice them directly to their health-care provider in order to move the relationship forward and ensure that patient needs are being met. The truth, however, is that when trust is broken, an open conversation may not be possible. If this is the case, concerns can be brought to a hospital's patient affairs office or the practice manager at a clinic. Very serious concerns can be taken to the provincial physician regulating bodies such as the College of Physicians and Surgeons.

These options offer patients an opportunity to address a concern that will then be shared with the doctor with the goal of coming to a resolution. When concerns are addressed this way, there is an opportunity for change. When concerns are raised on an online rating site, most physicians will never be aware of them.

Fortunately, in your situation, your friend's recommendation should hold more weight than an anonymous review. It's understandable how negative comments may cause some concern, but by keeping an open mind, it will hopefully set the stage for a positive and trusting relationship with this new doctor.

Dr. Sheila Wijayasinghe is the medical director at the Immigrant Womens' Health Centre, works as a staff physician at St. Michael's Hospital in their Family Practice Unit and at Hassle Free Clinic, and established and runs an on-site clinic at Women's Habitat Shelter in Etobicoke. Follow her on Twitter @DrSheilaW

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