'Kuchikomi' ratings put the squeeze on the medical profession


Not far behind media coverage of the coronavirus pandemic per se have been reports on how medical facilities and the workers therein have been suffering as a consequence. 

Shukan Jitsuwa (Sept 23) turns its attention to sites known as byoin kuchikomi, which invite patients or their families to rate their satisfaction with hospital treatment and/or services. 

A low ranking, needless to say, can result in patients taking their business elsewhere. 

"For quite some time now, the tabelog sites for restaurants were able to boost rankings by employing paid reviewers," says the operator of a pediatric clinic in Tokyo's Edogawa Ward. "From around last year, something similar began to happen with hospitals. This has led to serious problems for patients who put their trust in online rankings." 

The problem with restaurant reviews on tabelog sites is that while in theory the comments and ratings are supposed to be made by amateurs who actually patronized the establishment, it has become common to procure the services of businesses to post glowing reviews -- a practice referred to as yarase. The word literally means "made to do it," but is defined in the dictionary as a staged event or prearranged performance. 

"There are also specialty businesses that arrange for posting favorable reviews on the kuchikomi sites of hospitals," a person employed in the IT sector tells the magazine. 

"In particular, these companies are said to target ear-nose-throat and pediatric physicians, and the hospitals and clinics where they work, both of which have suffered from sharp declines in patients due to the coronavirus pandemic," he explains. 

The aforementioned pediatrician admits, with embarrassment, that he, too, procured such services. 

"Our hospital is one with close ties to local residents. Normally we were ranked at 4 on a scale of 5, but a lot of negative comments were posted about some of our younger physicians, and the rating dropped to 2," he explains. "I was approached by telephone by one of these kuchikomi specialists, who told me, 'We can raise your ratings.' I decided to procure his services, for which I paid 300,000 yen." 

Normally in kuchikomi sites, the organization being rated cannot alter or delete negative comments. It is possible to request that a post be expunged, but the site will not take action unless it is clearly demonstrated that the post is in violation of the site's rules. 

In any event, thanks to its securing of professional assistance the pediatric site's rating was brought back up to 4. 

An ENT specialist in Tokyo's Koto Ward tells Shukan Jitsuwa that he was approached by a yarase specialist. 

"He told me that a new clinic had just opened in front of the station, and despite it's not being in operation for any length of time, it was already flaunting rave reviews from patients," the doctor said.

A medical writer remarked, "Some of these kuchikomi operators are outright crooks, going so far as to telling doctors that if they don't pay for their service, they'll concoct a scandal, or arrange for negative posts that will cause the clinic's ratings to plummet." 

It may be stating the obvious, but medical facilities, into which people entrust their health and very lives, shouldn't be in the position of being coerced to pay money for favorable ratings. The writer concludes with the hope that the authorities will subject this unethical racket to rigorous investigation.

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I note when reviewing books on, the site displays "verified purchase" to confirm that the posting reviewer has actually purchase (if not necessarily read) the book. Due to medical privacy concerns, it's virtually impossible to make public that an individual has, in fact, consulted with a hospital or doctor. So I can see why this whole business could be problematic. Paying a service to post a glowing review online is almost like paying protection money to the yaks.

3 ( +4 / -1 )

This is a recipe for disaster, medical professionals will unavoidably have some negative feedback because of the nature of their work, being honest and telling the patient their problem has not treatment, or that they will have to wait to see how they react for example, will not sit well with some patients. But the less honest will have less problems with agreeing with patients in order to keep them happy, even if it means not doing what is actually best for them. This will mean the more professional the services are the more likely they will get some bad reviews.

Then unethical operators will make thing much worse, risking the health and lives of people with manipulation of the rankings to favor people willing to pay, which are exactly the worst kind of places a vulnerable patient should visit.

A kuchikomi service is obviously very useful and well managed would force many places with lousy service to improve or leave business, but because of the topic being so delicate it is not appropriate to leave it for anybody to just run it as he likes, without a proper system in place to stamp out abuse and protect the privacy of the reviewers hearing about a tragedy because of one of those sites.

-4 ( +1 / -5 )

Similar thinking was used by the K-pop industry to make it successful on a global scale (i.e. setting up bots to pump up the likes on YouTube to record numbers; yes, everyone fell for it).

5 ( +6 / -1 )

It is false what NCIS Reruns said about Amazon. While it is true that Amazon does confirm purchase, there are book services where the author pays for fake recommendations. The fake recommender merely purchases a copy of the book as part of the 'service.' This 'service' also includes hiding bad reviews. I have contacted Amazon but they have no incentive to get rid of falsified 'good' recommendations. I know someone with a book ion Amazon with 'glowing reviews,' although by any objective measure the book is terrible. Bad reviews are pushed so far down or removed through author complaint. Amazon is not an honest book store. If there are no bad reviews found on a book, any book, then you can expect fishy behavior in almost all cases.

-1 ( +0 / -1 )

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