Rebecca Fernandez

I agree that this list is really more of a "Companies that take the best care of their employees" list than a "best places to work" list.

However, I think most people who have worked for a mission-oriented organization have also experienced the downside... being pushed to work longer, harder, and for less, because you care about the goals. So to me, that's where the "taking care of your employees" comes into play as being an important bit of the picture.

In other words, I agree with Ruth when she says that a company can use perks to free up their employees' minds to focus on their mission. A company whose mission I believe in, but who doesn't pay me enough to afford to put my kids in a decent daycare or who leaves me with health benefits so poor that I'm going broke, is not going to get the same level of work out of me, because I'm split between what I want to do and what I need to take care of. Likewise, a company that gives me a great salary but doesn't make me feel that my work is important will probably also get less than my best effort, because "good enough" is going to be the typical outcome when there's no appreciation for doing better.

So basically, I think that when the "perks" are there to support employees as they work on a mutually-valued mission, they serve the ideal goal: getting the best work out of each employee. When either piece is missing to a large enough degree, that quality of work is going to suffer.

And there's a third piece, which is autonomy. It doesn't matter how much I believe in a company's mission--if they micromanage the way I staple my reports, I'm going to be resentful.

Well, they're not really preventing communities from reviewing them, are they? Instead, they're having patients agree not to do it. But such reviews are anonymous, and it's not as if the doctor can prove who did it, nor would the agreement likely stand up in court. I think they exist to prove a point.

I can see where doctors are coming from. There's no safeguard against patients (or enemies!) with a vendetta, those who don't understand why something happened the way it did but won't go back and ask the doctor, those who think they know more than a trained professional, etc.

I think a combination of public reporting on licensing violations and ethics complaints (which most states have), making their stats available (which many doctors do), and allowing anonymous patient polling of the sorts of things patients are actually qualified to assess (bedside manner, availability, etc.) is a fair system. And it would be great if more doctors offered monthly "meet the doctor" programs, like many OBs and pediatricians do.

Opening up a "tell us what you think of this guy, and he can't respond or you can sue him" box is probably not.

Incidentally, I don't think these sites benefit students and professors, either. Students tend to inflate the ratings of "easy" professors and lower the ratings of "hard" ones. But does this tell you anything about the professor's teaching skills, the value of the material in her course, etc.? It's the rare 19 year old who realizes the importance of taking challenging courses, yet many professors are finding their careers depend on student reviews! Kind of depressing.

I still think the best way to find a doctor is still to ask your other doctors. You get a better perspective--my GP might tell me, "Ok, this GI doc can be really blunt and short with patients, but he's the best in the city. It's worth dealing with that." Whereas my aunt might say, "He was a total jerk. I went to <less qualified and less experienced provider> and he was great. <except that he misinterpreted my symptoms and took six extra months to figure out what was wrong with me>."

I guess I have a lot of sympathy for doctors, though. I have seen many, many individuals who go around telling skewed versions of what happened with a doctor, but when you press for details, it's apparent that there was something more going on. And that the patient never bothered to go back and ask the doctor why she made this decision or that one.