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.
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.
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