This is not about the John Lovitz show. [Though I do vaguely remember watching some spoof of it on the Simpsons where the character just kept repeating "It Stinks. It Stinks. It Stinks" while lying on the footprint-proof berber carpet of our gameroom floor, probably in an oversized hand-me-down dad tee].
I'll admit, I dabbled in the online review arts. It was the late 2000s and I'd just returned to my home city, but instead of being trapped in the suburban Blair Witch Project of my actual adolescence, I was in the vibrant urban inner loop, where increasing gentrification and a poorly-enforced (mostly free) state-of-the-art light rail system made new pockets of the sprawl accessible to even the faintest of hearts. I was in the process of reinventing myself, which you still could do in the hazy years between the decline of Friendster and MySpace [and thank GOD Geocities and Angelfire] before the complete armageddon of Facebook and Instagram and viral videos that could RUIN YOUR LIFE, with the confidence of a 20 something professional student surrounded by an endless rotating almalgam of insta-friends and the newfound knowledge that alcohol makes most social anxiety bearable. [So much for that one unfinished half-hearted beer at that one frat party in college]. I had heard about a burgeoning website from a friend and was intrigued by the premise: join this site, try new places and write some witty banter.
They claimed to want laypeople to chronicle their experiences - from fine dining to the wait time at the local DMV - no detail was too mundane - and the site rewarded both proclivity and originality. The more authentic your vernacular, the more people liked your reviews, earning you more in trust capital. A harbinger of the food-snob movement, they didn't want you just eating at your neighborhood chainstream restaurant every day [though that Olive Garden monologue was pure comic gold]. You had to get out into uncharted territory; a previously-un-reviewed haunt was a gold mine. Why else would one go to a Maritime Museum? It was intoxicating. Here I was, a vegetarian with almost no culinary know-how and the palate of an early American pioneer with a burnt tongue, interjecting my personal opinions onto the universe. It didn't matter if I couldn't try the signature dish, I could still joke about the decor. Or write a silly haiku about a failed date. Or utterly destroy a particularly obnoxious spot with a one star review [a tactic I learned from a long summer memorizing Pitchfork while waiting for mud to cook].
Not only did no one question my authority on such subjects, I was rewarded with an "Elite" status, invites to parties, and free swag. I never felt more alive, more attune to the latest and greatest in my underappreciated city. Review of the day was a personal victory. Constantly challenged to outsnark my last snark, it became solely an exercise in creative writing and I realized meant utterly nothing. [Though it was endlessly entertaining to listen to a particularly well-spoken attending read some of my thoughts aloud a few years later with the quintessential question "What does 'douchey' mean?" Seriously what I wouldn't give to recreate the scene as a one-act play]. I kept up the charade during my transition to New England, until the overwhelming fatigue of residency and complete seasonal affective dysfunction prevented me from wanting anything but the warm and comfortably familiar.
Now slightly older, and making efforts to be more humble and much less vegetarian, I conveniently blacked out that whole segment of my internet existence until I recently found myself on the other side of smoking gun. As part of an increasingly "customer-oriented" industry, I am now getting a taste of my own medicine as I find myself at the complete mercy of the whims of my patients. The medical care I actually provide is of equal or lesser value to the more superficial aspects of the experience - from the waiting room decor and friendliness of receptionists, to the unrelated time spent in the emergency room or the pain of the IV. Very little of my work is visible - it's impossible for anyone under anesthesia to accurately review my technical skills in the operating theater - so it all comes down to bedside manner and communication. And, as a classic example of selection bias, the only people who actively go out of their way to write an online review of their doctor usually feel either very strongly pro or inexorably con. A losing battle. And yet, try as you might to ignore the nay-sayers, it still hurts. Even moreso when done anonymously.
The other piece of the doctor-review paradox is that as a general surgeon, most of my work involves some level of urgency, emergency, pain or dysfunction. No one wants to come see me. It's not by choice. Even the happiest of success stories didn't initially seek me out like, "hey I'm gonna see if I can get a bowel obstruction today." An even smaller percentage of my particular demographic of patients actually use the internet frequently enough to know how to post a review. Those who do venture to provide public feedback must first overcome the taboos of writing about "not-dinner-table-appropriate" topics like bodily functions, and secondly risk the very basic tenant of patient privacy when they decide what to disclose. Given the above-described fallacies in this feedback loop, it's disheartening to think administrative types can use these sorts of surveys to judge the quality of care provided.
I say this as a very young physician with a small denominator; any small move can send you reeling wildly between 1 and 5 stars. I don't have any terrible reviews yet, but it will happen. And I'll definitely be upset. Assuming with more time and volume it will all be a wash, but how many overworked underappreciated and anonymously eviscerated docs burn out before that point?
In summary: don't believe every thing that you read. [Get a parking violation and a maggot on your sleeve.]
I'll admit, I dabbled in the online review arts. It was the late 2000s and I'd just returned to my home city, but instead of being trapped in the suburban Blair Witch Project of my actual adolescence, I was in the vibrant urban inner loop, where increasing gentrification and a poorly-enforced (mostly free) state-of-the-art light rail system made new pockets of the sprawl accessible to even the faintest of hearts. I was in the process of reinventing myself, which you still could do in the hazy years between the decline of Friendster and MySpace [and thank GOD Geocities and Angelfire] before the complete armageddon of Facebook and Instagram and viral videos that could RUIN YOUR LIFE, with the confidence of a 20 something professional student surrounded by an endless rotating almalgam of insta-friends and the newfound knowledge that alcohol makes most social anxiety bearable. [So much for that one unfinished half-hearted beer at that one frat party in college]. I had heard about a burgeoning website from a friend and was intrigued by the premise: join this site, try new places and write some witty banter.
They claimed to want laypeople to chronicle their experiences - from fine dining to the wait time at the local DMV - no detail was too mundane - and the site rewarded both proclivity and originality. The more authentic your vernacular, the more people liked your reviews, earning you more in trust capital. A harbinger of the food-snob movement, they didn't want you just eating at your neighborhood chainstream restaurant every day [though that Olive Garden monologue was pure comic gold]. You had to get out into uncharted territory; a previously-un-reviewed haunt was a gold mine. Why else would one go to a Maritime Museum? It was intoxicating. Here I was, a vegetarian with almost no culinary know-how and the palate of an early American pioneer with a burnt tongue, interjecting my personal opinions onto the universe. It didn't matter if I couldn't try the signature dish, I could still joke about the decor. Or write a silly haiku about a failed date. Or utterly destroy a particularly obnoxious spot with a one star review [a tactic I learned from a long summer memorizing Pitchfork while waiting for mud to cook].
Not only did no one question my authority on such subjects, I was rewarded with an "Elite" status, invites to parties, and free swag. I never felt more alive, more attune to the latest and greatest in my underappreciated city. Review of the day was a personal victory. Constantly challenged to outsnark my last snark, it became solely an exercise in creative writing and I realized meant utterly nothing. [Though it was endlessly entertaining to listen to a particularly well-spoken attending read some of my thoughts aloud a few years later with the quintessential question "What does 'douchey' mean?" Seriously what I wouldn't give to recreate the scene as a one-act play]. I kept up the charade during my transition to New England, until the overwhelming fatigue of residency and complete seasonal affective dysfunction prevented me from wanting anything but the warm and comfortably familiar.
Now slightly older, and making efforts to be more humble and much less vegetarian, I conveniently blacked out that whole segment of my internet existence until I recently found myself on the other side of smoking gun. As part of an increasingly "customer-oriented" industry, I am now getting a taste of my own medicine as I find myself at the complete mercy of the whims of my patients. The medical care I actually provide is of equal or lesser value to the more superficial aspects of the experience - from the waiting room decor and friendliness of receptionists, to the unrelated time spent in the emergency room or the pain of the IV. Very little of my work is visible - it's impossible for anyone under anesthesia to accurately review my technical skills in the operating theater - so it all comes down to bedside manner and communication. And, as a classic example of selection bias, the only people who actively go out of their way to write an online review of their doctor usually feel either very strongly pro or inexorably con. A losing battle. And yet, try as you might to ignore the nay-sayers, it still hurts. Even moreso when done anonymously.
The other piece of the doctor-review paradox is that as a general surgeon, most of my work involves some level of urgency, emergency, pain or dysfunction. No one wants to come see me. It's not by choice. Even the happiest of success stories didn't initially seek me out like, "hey I'm gonna see if I can get a bowel obstruction today." An even smaller percentage of my particular demographic of patients actually use the internet frequently enough to know how to post a review. Those who do venture to provide public feedback must first overcome the taboos of writing about "not-dinner-table-appropriate" topics like bodily functions, and secondly risk the very basic tenant of patient privacy when they decide what to disclose. Given the above-described fallacies in this feedback loop, it's disheartening to think administrative types can use these sorts of surveys to judge the quality of care provided.
I say this as a very young physician with a small denominator; any small move can send you reeling wildly between 1 and 5 stars. I don't have any terrible reviews yet, but it will happen. And I'll definitely be upset. Assuming with more time and volume it will all be a wash, but how many overworked underappreciated and anonymously eviscerated docs burn out before that point?
In summary: don't believe every thing that you read. [Get a parking violation and a maggot on your sleeve.]
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