While power has indeed shifted into the hands of the consumer when it comes to buying a car or choosing a restaurant, this revolution -- what Rothschild terms "Yelpification" -- hasn't, well, revolutionized health care.

Writing in the New York Times, Ron Lieber attributed the lack of authoritative doctor reviews to patients' unwillingness to do the actual reviewing. The problem, he said, is one of basic supply and demand: "Many people want this information, and more consumers would trust it if the sites had more robust offerings." While Vitals.com is accruing the numbers, it has yet to make the impact that its model, Yelp, has. Other sites, like Healthgrades and RateMDs remain similarly under the radar. And while Yelp itself, along with its paid counterpart, Angie's List, feature reviews of doctors and clinics, questions over just how reliable the information they provide is takes on greater significance when applied to something as important, and personal, as health care.

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If patients' alternating fear or idolization of their doctors does, as Lieber contends, prevent them from wanting to voice their opinions online, then Vitals' granting of anonymity to reviewers should help them to be as open as they want in composing their reviews. Part of the problem, suggests Rothschild, is that we don't tend to think of the patient-doctor relationship in terms of buyers and sellers. With the subtly incendiary tagline, "Where doctors are examined," Vitals attempts to reconfigure the power balance in favor of the "buyer" -- in this case, the patient.



But the redistribution of power to patients has understandably been met with some trepidation -- in the wrong hands, it can be wielded to defame and potentially destroy the career of doctor, who has little recourse against slanderous accusations.

"Doctors are a little bit helpless," said Ericka Adler, a lawyer who represents physicians. While there are ways of extracting an anonymous poster's identity, such as through a Doe subpoena, this can only be done if the comments rise to the level of defamation. Adler says she only advises her clients to pursue a lawsuit if the comments are truly terrible -- like, "This man is a Nazi" terrible. Some of the sites recommend that disgruntled physicians respond to their detractors, but Adler warns that this can only make things worse. A doctor who recognizes the specifics of a reviewer's case and attempts to set the record straight is in danger of violating confidentiality laws, and "could open some kind of conversation that shouldn't be opened."

When things do go wrong, they do so spectacularly: earlier this year, a patient was ordered to pay $12 million in damages for the all-out war she launched against her plastic surgeon. But while this woman was able to single-handedly destroy her doctor's career, not to mention his life, her actions went beyond physician-review pages, which are usually moderated. According to court records, she created her own website and harassed the doctor's other patients with allegations that he wasn't board certified, among other accusations.