[tptacek]

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.

[namewithhe1d]

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

[tptacek]

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.