Sorry, poor choice of words. By random I mean someone whose opinion is informed only by their impression of the care received, which was specific to them.

Sites like www.ratemds.com are encouraging patients to review their doctors like they would review a restaurant or hair salon on Yelp. A collection of customer reviews of a restaurant can be very useful in two ways. First, the main point of a going to a restaurant is the customer experience, which is more or less the same for everyone. If a lot of people are leaving a restaurant happy enough to write a favorable review on yelp, that's pretty a good indicator that you may enjoy the experience as well. Furthermore, many customers are well-qualified to critique the details of the service. The food, environment, atmosphere, busy times, and various other features can be described. For something like a hotel or a hair salon, those feature descriptions will probably be more important. You can look for mismatches between what's advertised and what the customers are saying

Doctors are different from restaurants in a critical way. The point of going to a doctor isn't to feel good about the experience (although hopefully you will) the point of going to a doctor is to get good, personalized, medical care. Ratemds draws focus to the incidental features which are useful but not especially critical (staff, punctuality) and on very vague evaluations of the doctors ("helpfulness" and "knowledgeable"). For the most part, the patients don't do an especially good job of rating the actual medical care.

In terms of surveying patients, all I really want to know is how many are dramatically unsatisfied. Occasionally I hear major complaints about caregivers from multiple people (extremely rude, very painful, etc.). That's about the extent to which I trust the average patient to inform my decision about what doctor is right for me, although I will admit standard Dental care (cleanings, fillings) is more reviewable than internal medicine.

I don't think people rate solely by how pleasant the experience was. The actual results do matter. Did this lead to the problem being solved or being better managed? Patients do care about such things.

There has been a great deal of focus on the delivery of procedures in health care and not so much on actual cures. Compensation is entirely based on procedures. A doctor may be rated on how a procedure was performed, but only a patient can decide if the result was good.

Perhaps a system that quantified a patient's health before and after an experience is a good way to go or over time is the way to go. If a doctor is able to keep his patients healthier, he's a good doctor. But that's pretty difficult to do with "random" ratings. Which is probably why word of mouth is probably more trusted. And doctors haven't figured out how to stop it.

Would it make sense to separate diagnosis from treatment? If the doctor diagnosing problems had incentives for maintaining health and keeping costs low, the doctors performing procedures could focus on delivering services instead of selling them.

I could also see that approach making sense in things like automobile repair.