Monday, August 31, 2015

Physicians' Perspectives on PRWs

Physician review websites (PRWs)—sites that permit patients and third-party reviewers to grade physicians in popular online forums—have become increasingly popular over the past few years.
Statistics that relate to this trend are as follow:

    • The number of reviews on, one of the first PRWs, has grown from 2, 475 reviews in 2005 to 112, 024 in 2010.  Today, the most popular physician review sites are Yelp and Healthgrades.
    • Younger patients, identified as Generation Y (also called the Millennial Generation), are the most frequent posters to PRWs (34 percent).
    • Almost half (44 percent) of patients are willing to go out-of-network to visit physicians with good reviews, even if it means spending more dollars on healthcare.
    • Patients use PRWs to select a physician on several factors (in order of importance): quality of care (48 percent); PRW rating (45 percent); and patient experience (40 percent). The physician qualities patients seek the most are ability to make an accurate diagnosis (34 percent), followed by listening and explanation skills.
    •  Regarding administrative aspects of the practice, patients are most interested in length of wait times, staff friendliness, and ease of scheduling appointments.
    • Of those patients who use the web to search for physicians, 35 percent select a physician based on good ratings, while 27 percent avoid those physicians with bad ratings.

Doctors feel that the majority of PRWs lack in sharing important physician information, such as languages spoken, gender, use of electronic health records (EHRs), and success in meeting quality care standards. Additionally, physicians state that lumping specialists with general practitioners on the same site and using the same rating scale is like comparing a taxicab to a jet.  For instance, a family care physician and a thoracic surgeon don’t provide similar services and thus shouldn’t be graded in the same manner.

In regard to wait times at physician offices, this is oftentimes due to patients and not physicians. For example, a patient who arrives 15 minutes late to an appointment can cause the remainder of the physician’s schedule for the day to run behind. Additionally, some patients require more of the physician’s time once in the examination room than others.

In regards to this, Dr. Cockerell states, “I am always conscientious of my patients’ time and strive to stay on schedule during clinic days. However, there are some days that I run behind because some patients have needs that take longer than expected. I ask my patients to please understand this because if they require extra time with me, they’ll receive it just like other patients.  I encourage all patients to discuss any concerns with me and to allow me the opportunity to resolve the issues before turning to review sites to post a negative review.”

The American Medical Association (AMA) has developed a policy that calls for the development of educational materials to help physicians identify legal options to protect them from targeted harassment and effective solutions to erroneous physician information posted online. AMA policy also supports the use of physician profiling to promote quality of care as long as the methods used to promote transparency and accuracy allow physicians the opportunity to respond in order to express their viewpoint.

Dr. Cockerell asks his patients to express their concerns to him during their appointments, and if that is not possible, to contact his office to allow the patient and a staff member to work together to resolve the issue.

American College of Surgeons (2013).  Online Physician Reviews: The Good, The Bad, and The Ugly. Retrieved August 30, 2015, from

Center for Advancing Health (2015). Using Physician Rating Websites. Retrieved August 30, 2015, from

Medical Economics (2014).  Physicians and Online Reviews: Patients Focued on Quality of Care. Retrieved August 30, 2015, from

The Wall Street Journal (2015). Doctors Check Online Ratings From Patients and Make Change. Retrieved August 30, 2015, from

2016 Practical Symposium Vail Conference Open For Registration

Dr. Cockerell and his staff are excited to announce that registration is now open for the 2016 Practical Symposium: Sharpen Your Dermatology, Clinicopathologic and Business Skills conference held in Vail, Colorado August 11-14.

The conference is unique in that it emphasizes clinicopathologic correlation and the working relationship between dermatologists and dermatopathologists in making accurate diagnoses and planning optimal treatment. It also emphasizes how clinicopathologic correlation can guide research, and new drug and device product development within dermatology. It is more important than ever to understand the close cross-fertilization that occurs among dermatology, dermatopathology, and industry.

The conference will provide a rich educational experience where the interaction among dermatology, dermatopathology, and industry will be explored in a number of different sessions and lectures throughout the symposium. The meeting will also allow ample opportunity for networking of attendees with industry leaders who will be welcomed into all educational sessions and social activities. Another innovative component that distinguishes this conference from others is that it includes sessions on business development insights for clinicians.

The meeting curriculum is a great fit for dermatologists, Mohs surgeons, dermatopathologists, pathologists, physician extenders, and other clinicians who would like to sharpen their dermatology and dermatopathology skills. The conference is also beneficial to residents and fellows preparing for certification examinations, attending physicians preparing for recertification examinations, and physicians in the industry who interact with clinicians or other researchers. Approximately 25 CME and 75 MOC credit hours will be available to be earned. There will also be a board review for residents and fellows.

Multiple support and promotional opportunities are also available, including support of receptions and workshops, print advertising, and organization branding opportunities.

The meeting will take place at the Marriott Mountain Resort nestled at the base of Vail Mountain. The natural beauty that surrounds the breathtaking luxury resort is reflected in a chateau-style atmosphere of warm elegance, cozy rooms, heated pools, outdoor recreation, and a luxurious on-site spa.  The meetings will primarily take place in the mornings and early evenings with abundant time for enjoying the beautiful Vail Valley region, which is spectacular in the summer months. Fun and engaging social activities will be offered to attendees, spouses and children, and guests.

For more information, please visit

Is Wine Good For Your Health?

For many years, medical research has been conducted on the health benefits of wine, but recent studies on the libation have shed some interesting findings. The general consensus is, yes, wine is good for your health given certain parameters. However, not all wines are created equal when it pertains to their value in elevating health due to the varied natural elements found in the different varieties of wine.

Flavonoids, which are found in a variety of fruits and vegetables, are metabolites that provide health benefits through antioxidant effects. A specific flavonoid, resveratrol, is a key component of red wine that has been shown to improve cardiovascular health. Procyanidins is a class of flavonoids that contain condensed tannins—a natural element that makes wine taste dry.  Procyanidins protect against heart disease. The skin of grapes used to make red wine contain large amounts of resveratrol and procyanidins, more so than white wine because red wine is fermented with grape skins longer than white wine.

The University of California, Davis, tested a variety of wines to determine which types have the highest concentrations of flavonoids. Cabernet Sauvignon had the highest flavonoid concentration, followed by Petit Syrah and Pinot Noir. Merlots and red zinfandels did not score as highly as the other red wines. White wine was found to have significantly smaller amounts of flavonoids than red wine varieties. The rule of thumb is the drier the red wine, the higher the flavonoid concentration. Sweeter wines, like white and pink wines, have fewer flavonoids.

Researchers have long known that light to moderate alcohol use, particularly in middle-aged men and women, reduces the risk of atherosclerosis that may lead to coronary heart disease. Atherosclerosis (ath-er-o-skler-O-sis) is a disease in which plaque builds up inside the arteries. The disease can affect any artery in the body, including arteries in the heart, brain, arms, legs, pelvis, and kidneys. This accumulation of plaque in the arteries may lead to heart attack, stroke, or death. Several risk factors may cause atherosclerosis, including a high-fat diet, smoking, sedentary lifestyle, age, and a family history of heart disease.

Moderate consumption, four ounces a day for women and four to eight ounces a day for men, of red wine has been shown in research studies to have the following health benefits:
    • Lower risk of heart disease and stroke: A daily dose of red wine provides enough procyanidins and resveratrol to protect against heart disease by reducing low-density lipoproteins (LDL) cholesterol (the “bad” cholesterol), removing chemicals responsible for causing blood clots, and decreasing blood clot-related stroke rates by 50 percent.
    • Cancer treatment: Another active antioxidant in red wine known as quercetin fights      cancer cells and inhibits tumor growth, particularly in colon cancer, according to the American Cancer Society.
    • Protection against neurological diseases: Resveratrol protects against cell damage that causes age-related mental decline as found in Alzheimer’s disease. The flavonoid also aids in the formation of nerve cells that is helpful in the treatment of Parkinson’s and Alzheimer’s diseases.
    • Weight loss: Ellargic acids inside a vineyard’s grapes have the power to delay the growth of fat cells and slow the development of new ones.
    • Mimics workout time: Resveratrol is responsible for heart-healthy benefits, such as  improved physical performance and muscle strength, and cardiovascular enhancements.
    • Promotes long life: Red wine drinkers have a 34 percent lower mortality rate than beer or vodka drinkers, according to a 29-year-long study. Any diet rich in polyphenols (found in red wine) protects against the development of chronic diseases.
Dr. Cockerell is co-owner—with his wife, Brenda—of Coquerel Family Wine Estates in Calistoga, California in the Napa Valley that produces world-class wines. The name “Coquerel” is an archaic French derivation of the family name Cockerell that was specifically chosen, as the goal of the vineyard is to produce French-style wines in the Napa Valley.  The vineyard is mostly dry-farmed and produces a number of grape varietals, including Sauvignon Blanc and Petite Sirah among others under the supervision of world-renowned wine specialist, Christine Barbe.  Coquerel produces award-winning Sauvignon Blanc, Chardonnay, Verdelho, Petite Sirah, Tempranillo, Pinot Noir and Cabernet Sauvignon wines that capture the essence of the vintage, variety, and site. For more information, please visit

Dr. Cockerell does not advocate excessive drinking nor does he encourage people to take up drinking just for health benefits. If you drink alcohol, please do so responsibly.

American Heart Association (2005). Cardiology Patients Page: Red Wine and Your Heart. Retrieved August 28, 2015, from

Brien S.E., Ronksley P.E., Turner B.J., et al. (2011). Effect of Alcohol Consumption on Biological Markers Associated with Risk of Coronary Heart Disease: Systematic Review and Meta-Analysis of Interventional Studies. BMJ; 342. Retrieved August 28, 2015, from

Mayo Clinic (2014). Red Wine and Resveratrol: Good for Your Heart? Retrieved August 28, 2015, from

Medical Daily (2015). Red Wine Burns Fat and Lowers Blood Pressure, Plus 5 Other Health Benefits for Winos. Retrieved August 28, 2015, from

MedicalNewsToday (2015). Wine: Health Benefits and Health Risks. Retrieved August 28, 2015, from

National Heart, Lung, and Blood Institute (204). What Is Atherosclerosis? Retrieved August 28, from

Yale-New Haven Hospital (2015). A Glass of Red Wine a Day Keeps the Doctor Away. Retrieved August 28, 2015, from