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04:17 PM

Doctors Take Dim View Of Users' Online Ratings

Doctors question small sample sizes and what ratings measure, but many peek at their own report cards anyway.

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Physician leaders are wary of online physician ratings but are interested in what patients have said about them, according to a recent survey by the American College of Physician Executives (ACPE). Moreover, most of the respondents agreed that ratings will become more important in the era of value-based reimbursement.

Only 12% of the physician leaders said that consumer rating websites were helpful and should be made more available. Twenty-six percent said they were a nuisance and provided no benefit, and 29% said that the sites were not used very much by patients and didn't really affect their organizations.

About 55% of the physicians believed 25% or less of their patients had used an online physician rating site, and 35% of respondents estimated that between 25% and 50% of patients visited those sites.

According to a recent Pew Internet survey, only 20% of Internet users -- a subset of all consumers and, therefore, of patients -- had consulted online reviews of particular drugs or medical treatments, doctors, hospitals or other providers. Just 3 % to 4% of Internet users had posted reviews of healthcare services or providers.

[ Doctors interact with patients online more than ever. Read HealthTap, Avvo Marriage Gives Consumers More Online Docs. ]

The small sample size is one reason why physicians distrust online consumer ratings, said Seth Glickman, MD, assistant professor of medicine at the University of North Carolina in Chapel Hill, in an interview with InformationWeek Healthcare. Glickman, an expert on patient experience surveys, pointed out that physicians also are concerned about the possibility that competitors might plant negative reviews. And there are concerns, he said, about whether the sites are measuring what makes patients happy or what represents good clinical care.

"For example, giving a patient an antibiotic prescription for a cold is not good medicine, but there's some evidence showing that when patients receive that prescription, they feel they've received better care," said Glickman.

Some of these issues carry over to external physician ratings that are more scientifically valid, such as those from Press Ganey, the National Committee on Quality Assurance, the Joint Commission and some health plans. The ACPE survey found that only 29% of respondents viewed these ratings as useful, while 14% regarded them as a nuisance and a time waster. Forty-one percent had a neutral opinion about these report cards.

In contrast, 75% of the respondents said their organizations rated physician quality internally, and 71% of the physician leaders said these ratings were valuable and that they supported their use.

Despite the overwhelming rejection of online consumer ratings of physicians, two-thirds of the respondents said they had viewed their own ratings on websites such as Healthgrades, Vitals and Angie's List. Of those who had looked at their report cards, 39% agreed with them and 42% partially agreed with them. Only 19% said the reviews were completely wrong.

This did not surprise Glickman. "Many of us are aware of the things we do well and the areas we need to improve on," he said. "When you have a well-designed survey instrument and you amass feedback from a critical mass of patients, you can see those themes emerge. It's a good sign that physicians are at least open to the possibility of what that information can provide and use it as a platform to figure out a way to improve the care they deliver."

As more consumers write and read reviews of physicians on these websites, he added, doctors will start to take them more seriously. "The more information that's available in the public domain, the more likely physicians are to review the information and to believe that it's valid, based on larger samples."

Meanwhile, he said, physicians should bear in mind that there are areas of health care, such as patient engagement and physician-patient communication, where consumer ratings can be insightful. "There's some good evidence that when we do better in those areas, we can deliver higher quality care at lower cost. Patients can provide valuable feedback in those areas, which can lead to higher quality care," he said. Of the 730 physician leaders who participated in the ACPE poll, 31% worked for health systems, 24% for hospitals, 20% for group practices, and 9% for academic health centers. Twelve percent were in private practice.

Clinical, patient engagement, and consumer apps promise to re-energize healthcare. Also in the new, all-digital Mobile Power issue of InformationWeek Healthcare: Comparative effectiveness research taps the IT toolbox to compare treatments to determine which ones are most effective. (Free registration required.)

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User Rank: Apprentice
1/28/2013 | 9:27:25 PM
re: Doctors Take Dim View Of Users' Online Ratings
"20% of Internet users -- a subset of all consumers and, therefore, of patients -- had consulted online reviews of particular drugs or medical treatments, doctors, hospitals or other providers. Just 3 % to 4% of Internet users had posted reviews of healthcare services or providers."

This is interesting to hear, considering the supposed trend of patients self-diagnosing through sites like WebMD, etc. It would be interesting to explore what type of reviews that 3% to 4% posted in regard to their healthcare service or provider -- based on previous research and trends I've seen on sites like Yelp, etc., I'm assuming negative.

Michelle McNickle
Associate Editor
InformationWeek Healthcare
User Rank: Ninja
1/24/2013 | 12:52:44 AM
re: Doctors Take Dim View Of Users' Online Ratings
I was in need to find a new doctor (the old one had poor manners and lacked any understanding of privacy). I went exclusively by online reviews and picked a new doctor. After my first visits I can only state that the reviews were spot on as were the many negative reviews for my old doctor.
Maybe it is that doctors don't stuff the ballot box with fake positive reviews as is the case with many other goods and services.
User Rank: Apprentice
1/23/2013 | 4:05:05 AM
re: Doctors Take Dim View Of Users' Online Ratings
I don't know -- it seems healthcare professionals may just want to overlook the obvious. Often, those who take the time to review something (or rate something) feel pretty strongly about it.
User Rank: Moderator
1/23/2013 | 12:05:13 AM
re: Doctors Take Dim View Of Users' Online Ratings
No, these ratings have lived out their time, chuck them. I am an old hat at this and found my doctor who had been dead ofr 8 years still shown and every time I get on one, easy to find flawed and errors and report card over all rating is joke, giving UCLA a C when it's th only place in the US to get some lifesaving procedures. These sites make money from advertising and ad exposure and could care less about accuracy about the doctors, and I'm not talking about what patients say, I'm talking the over all site. Go look up Gary Michelson on Healthgrades who retired at least 10 years ago who's on the Forbes list of riches as he won a few billion from Medtronic on patents they abused, you'll see him still on Health grades open for new

Myself and a bunch of doctors went through all this a couple years ago and even compared the data to Medicare's listings and there's didn't have as much but the government has was better...time to fry these sites... yellow page type directory is fine. AMA even interviewed me as the number of dead doctors we found was amazing:) They practice medicine on these sites in the after life:) Every time I I tweet one of these posts the RTs light up.

Doctor's don't have time to chase all these sites for accuracy, who are they kidding but now we have the same thing with consumers not liking it either with data collected about yourself riddled with errors. Check out some of the Attack of the Killer Algorithm posts, every day events with flawed data and dirty code that can deny. PS forgot to add I'm a data base persona not just one complaining so have some first hand expertise here so thought I should say that to distinguish my comments here:)
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