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Comment by namewithhe1d | Hacker News Reader

True, but Dr. Offices are a business. And in smaller offices, the Dr. is the Owner/Manager. Frankly, for the vast majority of Dr. visits, you're there for routine or minor care, and a badly run business will simply keep me away.

I don't care how good a chef at a restaurant is, if it takes me 2 hours to order and wait for food, the silverware is dirty, and the surroundings are miserable, I'm never coming back.

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The concern is that increased attention to superficial details will advantage poorer doctors who are better at customer service, which isn't a win for consumers.

Already in this story you see the effect of massage therapists being statistically advantaged over internal medicine doctors. That's obviously silly, but the same effect happens within the medical profession, between different doctors.

It's true in the short run, though it will also place a much higher value on those doctors that are good at what they do, and run a good business. And those are the offices that will benefit the best in the long run.

/endrant

At the very top tier, the most advantaged professionals will be those doctors who are fundamentally effective and apt at customer service. Surfacing them is a win for consumers.

But the next tier after that will be a raft of professionals who are not necessarily effective, but still apt at customer service. Elevating them is a loss for consumers.

The question you then want to ask is, is it harder to be good at customer service, or harder to be good at internal medicine? I think customer service is easier, and thus worry that the second tier will be the largest of the tiers.

An easy response to this is to say that doctors will learn to get better at customer service. Maybe. But the effect I'm talking about also happens if we stipulate that none of these professionals really change at all, and instead the market just changes the way we sort them. I think that is likelier than the scenario where doctors who are not simultaneously good at medicine and managing an office suddenly figure out customer service.

Small single practices office are going away. Doctors are corporatizing either by merging with other practices or being bought out by hospitals or hospital groups. The reason: electronic medical records and new regulatory requirements. The burden of these regulations has been making it increasingly costly to run single doctor practices. So the result is less choice (in business) and less control for the doctor over the patient experience.

In conclusion, it is a nice idea to think of the doctors as "business people" but the reality is there are fewer and fewer who are. Most are now employees in a large corporate system.

(also +1 to the sibling comments)

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