Practo and rating systems

The lack of a rating system means Practo is unlikely to take off like other similar platforms

So yesterday I found a dermatologist via Practo, a website that provides listing services for doctors in India. I visited him today and have been thoroughly disappointed with the quality of service (he subjected me to a random battery of blood tests – to be done in his own lab; and seemed more intent on cross-selling moisturising liquid soap rather than looking at the rash on my hand). Hoping to leave a bad review I went back to the Practo website but there seems to be no such mechanism.

This is not surprising since doctors won’t want bad reviews about them to be public information. In the medical profession, reputational risk is massive and if bad word gets around about you, your career is doomed. Thus even if Practo were to implement a rating system, any doctors who were to get bad ratings (even the best doctors have off-days and that can lead to nasty ratings) would want to delist from the service for such ratings would do them much harm. This would in turn affect Practo’s business (since the more the doctors listed the more the searches and appointments), so they don’t have a rating system.

The question is if the lack of a rating system is going to hinder Practo’s growth as a platform. One of the reasons I would go to a website like Practo is when I don’t know any reliable doctors of the specialisation that I’m looking for. Now, Practo puts out some “objective” statistics about every doctor on its website – like their qualifications, number of years of experience and for some, the number of people who clicked through (like the doctor I went to today was a “most clicked” doctor, whatever that means), but none of them are really correlated with quality.

And healthcare is a sector where as Sangeet Paul Chaudary of Platform Thinking puts it, “sampling costs are high”. To quote him:

There are scenarios where sampling costs can be so high as to discourage sampling. Healthcare, for example, has extremely high sampling costs. Going to the wrong doctor could cost you your life. In such cases, some form of expert or editorial discretion needs to add the first layer of input to a curation system.

So the lack of a rating system means that Practo will end up at best as a directory listing service rather than as a recommendation service. Every time people find a “sub-optimal” doctor via Practo, their faith in the “platform” goes down and they become less likely to use the platform in the future for recommendation and curation. I expect Practo to reach the asymptotic state as a software platform for doctors to manage their appointments, where you can go to request an appointment after you’ve decided which doctor you want to visit!

Potential investors would do well to keep this in mind.

Update

Today I got an SMS from Practo asking me if I was happy with my experience. I voted by giving a missed call to one of the two given numbers. I don’t know how they’ll use it, though. The page only says how many upvotes each doctor got (for my search it was all in the low single digits), so is again of little use to the user.

8 thoughts on “Practo and rating systems”

  1. Interesting analysis…

    Agree with the conclusion. Practo needs to build a trusted services marketplace else they are just another listing service. Even 2 way services market places are gamed for ratings and healthcare is one aspected where trusted references count the most hence the word of mouth market spreads…Even in brand based services like Apollo its the doctor that pulls the traffic in. With the woeful state of the medical malpractices state in India this problem is not easily solvable but to push the issue on ebay style ratings…

  2. To avoid legal issues with Doctors and generally the sticky issues with Negative ratings, I expect Practo to move into a social rating system.

    1) Only upvotes – No Downvotes Something like Facebooks like button
    2) Login with facebook to see the doctors recommended by your friends. Again nothing negative here – But you can get an idea of good Doctors
    3) Private collection of negative ratings and punishing the Doctors on search rankings with high negative ratings. No public display of the same.

    3 is especially important. As long as good Doctors get more patients and bad doctors do not get any patients, Consumers will trust Practo.

    Ubers rating of Drivers and Passengers is also collected but not published…

    1. Uber’s ratings are made available to both driver and passenger as soon as there’s a match. So if I’ve got a badly rated driver I can cancel ride.

      Agree about point 3 that you’ve mentioned being important. But once it’s known that order of search rankings is in terms of ratings I expect doctors to start fighting with Practo on why they’re so low, etc.

      And number of upvotes tells me nothing – unless i konw total appointments made via practo. becasue if i go to a doctor who takes appointments exclusively through practo, that guy is likely to have more upvotes on practo than one who takes only a small portion of his appointments via practo.

      So I see this as an intractable problem

    2. Ubers customer (as in you) rating is collected but not shown to you, its shown to the driver (there was a hack to expose it) – This is what I expect Practo to do somewhat in reverse. Your doctors rating is collected but not shown …

      As for the search ranking part. You expect a deterministic model, Practo can easily change search results in an probabilistic A/B test model show for some searches and hide from others. Change order for some searches and hide from others. Bascially for bad doctors net effect is you will get less patients on practo… Like google search can be one complicated big black box behind which you can have a lot of fun …

      Upvotes become useful with Facebook / Social recommendations and are also interesting signal by themselves which increases your confidence with this doctor. For quantitative users used to 8.59 / 10 ratings on IMDB. These ratings are not ideal, For normal users.. upvotes do mean social validation. And scale (which would increase your upvotes) is a form of social validation. As a friend told me, the longer the q to meet a doctor – the better the doctor…

      This problem is tractable but requires user scale which they have …

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