health care

Can the patient assess the caregiver?

Following the current trend, Independer has started to compare healthcare providers. But can the patient form an objective opinion and does it not lead to further tunnel vision in healthcare?

<h3/h3> The healthcare provider, in the following case a general practice, receives an arithmetic average grade based on 9 criteria that are filled in by the patient. The fact that there is an arithmetic mean is already dubious. Do you consider all of these criteria equally important in the criteria below? Expertise seems to outweigh the telephone accessibility. And so the different criteria are strongly subject to subjective views.

  • Make an appointment
  • Availability by phone
  • Accessibility
  • Hygiene
  • Respect
  • Time and attention
  • Expertise
  • Understandable information
  • Result treatment


People are dependent on a number of things when assessing situations, products and / or services. Experience and comparison material are of great importance here.

We build up experience with a product or service over time and it is strongly determined how often we purchase that product or service.

Because people consume bread almost every day, they can gain a lot of experience in a relatively short period of time. Not only with regard to price but also the quality of the product. If you don’t like the bread you buy today, buy another bread immediately tomorrow. The market has a direct incentive in this way.

In the case of purchasing care products, you hardly gain that experience. Because how often do you undergo knee surgery, wound treatment or more complex care products such as oncology and cardiovascular surgery? You hope that you never come into contact with these care products. Experience is not an essential part of our learning and judgment.

Another part is the assessment itself. Man is extremely bad at giving absolute judgments. Because what do you think is good telephone accessibility? That you have to wait 2 or 5 minutes? Or that multiple numbers are available? The patient is expected to make an absolute judgment.
In my piece of distributive management, I have shown that people need comparison material. “It is very difficult to estimate distance in an absolute sense. You can very well estimate whether the object is closer or further to another object [depth]. ”Without a good comparison, a patient cannot actually form an objective opinion about a care provider. This only works if a patient places the two care providers next to each other simultaneously on the same criterion. A condition that hardly occurs in daily practice.


In addition to the general shortcomings of man to assess something, we are also dealing with a sector where there is high-quality product and service. A good minimum knowledge is required for a proper assessment of this. The Independer criteria list states “expertise”. Can a patient really assess the expertise of a general practitioner? It will at best reflect a subjective preference and not so much the substantive quality of the GP. To do this, the patient must purchase at least several products in a short time and, based on the different treatments, must form a weighted opinion.

And with “result treatment”, the pitfall of expectations is just around the corner. Patients are, unreasonably, demanding on caregivers, while the limitations of medical knowledge cannot meet many expectations. Now measure Independer opinions or actual quality. Even if there is a large database of opinions, this problem will not diminish. The assessment figures become seriously polluted as a result of applying an arithmetic average and never give a good picture of the performance of a care provider.

Tunnel vision.

The shortcomings of rating lists such as Independer’s have been discussed often enough. It leads to tunnel vision and often to undesirable behavior [see financial sector, but also the attitude of the citizen that is becoming increasingly unreasonable in his behavior] On the one hand, the patient will take the assessments seriously to some extent, which forces caregivers to focus on the criteria of the list. Because these lists are extremely limited, other important issues lose attention and disappear from view. Matters such as trusting physician-patient, which is of great importance in recovery. And these are things that are difficult to capture in an Independer list, which offer a false sense of security. The quality of care will then slowly erode.

It is time for the Netherlands to have a fundamental discussion about health care. What kind of care do we have in mind and how do we organize care?


It is time for the Netherlands to have a fundamental discussion about health care. What kind of care do we have in mind and how do we organize care? Is it about quality and what is quality? Is that accessibility by telephone or the remedial / resolving power of care? This discussion should be conducted politically and socially where it is now left too much to the market. The healthcare provider but also the patient deserve better than a 9 point list from Independer.