I continue to be intrigued by the strong growth of Angie's List, a subscription consumer rating service that now claims over 500,000 subscribers. That's an impressive number of subscribers for any kind of consumer information service, and it's even more impressive because its subscribers contribute all the content. Indeed, Angie's List has achieved so much success it's confronting novel new issues as it grows and matures.

Now, Angie's List is moving to expand its ratings beyond plumbers and home contractors to include physicians, pharmacists, dentists and even health plans. I wouldn't go so far as to call this move into healthcare a risky or gutsy one; indeed it makes perfect sense. What Angie's List is diving into, however, is the large, complex, emotional and politically-charged world of healthcare provider ratings. There have to be at least a dozen sites currently offering physician ratings alone - Xoova, Vitals.com, ZocDoc, are just a few that spring to mind. We also previously noted that even ratings pioneer Zagat's has entered the fray.

Rating physicians and dentists on one level is fairly easy. Anyone can opine on how nice they are, if their offices are clean, or if they were kept waiting. But these are so-called soft assessments. What really matters is not how nice a doctor is, but how competent a doctor is. That's where things get complicated and ugly. The healthcare industry's infighting over defining and executing "outcomes measurements" and a related issue of "risk adjustment" (essentially, adjusting scores to reflect providers that routinely deal with sicker patients) has been going on for years, with no resolution.

Angie's List is right to stick with soft assessments. They play to its strengths and are far less controversial (although a growing number of physicians are saying that being rated by patients isn't fair for various reasons). But here is what bears watching: How large and robust will these ratings become? Though Angie's List subscribers represent an active and engaged community that stands a distinct chance of raising the bar for healthcare provider assessments, the more the site tries to cover, the thinner its content becomes. If Angie's List rates 12 physicians in a major city, has it succeeded or failed? I don't think anyone yet knows the answer to that, so stay tuned.

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