Are Physician Ratings on the Web Useful?


     Here is a typical scenario.  You’re need a good doctor and decide to surf online doctor reviews.  
Millions do it every year.  By some estimate, over 60% of people looking for a new doctor start their
search on-line.  What most don’t appreciate is that while product reviews often help in making a wise
decision, the same is rarely the case with online reviews of doctors.

     The first problem is that few doctors have enough online reviews to make them meaningful.  Often
there will be no more than one or two reviews.  If more than a couple of reviews exist, most will be quite
old.  Sometimes there will be a single review by someone that apparently loved the service.  Equally
likely, there will be a review by a disgruntled drug seeker angry about not getting a prescription they can
resell for a profit.  Disgruntled drug seekers don’t like paying for an office appointment to only walk out
empty handed.  When the doctor then gets slammed in an online review it’s to no one’s surprise.  
Sometime a bad review is the cost of being an ethical doctor.

     For many products and services, online reviews and ratings help assess quality.  So, why isn’t it the
same for hospitals and doctors?  The problem is that there is much more to quality medical service than
patient satisfaction.  To put the problem in perspective, here are a few thoughts to consider:

     1.  Most patients like their doctor and write overly glowing reviews.  On the other hand, unusually
negative reviews may be based on factors beyond the doctor’s control.

     2.  Online ratings rarely provide statistics that can put the review in proper perspective.   For
example, how many patients has the doctor treated with a given condition?  How many fared better or
worse? Does the doctor over test or under test?  Is it a doctor that only fills expectations like prescribing
an antibiotic even if they know it’s a virus?  Unfortunately, a doctor can get better ratings by not
opposing patient expectation than by practicing good medicine.

     3. In a 2012 JAMA study involving 52,000 patients, the most satisfied patients fared worse.  
Interestingly, even though satisfied patients used fewer emergency services, they spent more on
prescription drugs and, testing and were more likely to die.

     4.  Many reviews focus on details like wait times and punctuality.  Unfortunately a large body of
research shows little correlation between these and quality.  Often these are staff related issues the
doctor has little control over.  Perhaps the doctor was assigned a grumpy nurse or receptionist that day.  
A feeling of insensitivity from someone on the staff can easily become a story about an insensitive
doctor.

     5.  While there are many websites posting reviews about doctors, most only publish simple facts from
public databases about where the doctor went to school or completed residency.  Other information is
frequently hijacked from their competitor’s review sites.  Hence, reviews or ratings may be little more
than a very small (statistically insignificant) sample of information endlessly scrapped from websites and
republished in different forms.  For example, one site may publish the reviewer’s full text.  Another site
may extract from the review in a simple thumbs up/down type evaluation.  Often comparing ratings on
different sites provides no new information.  It’s all the same information republished in disguised forms.

     On a positive note, a complementary online review likely means the doctor has good bedside
manners.  In general, that’s a plus since having a favorable patient-doctor relationship is key to open
communications and trust that gets all the facts on the table.  Even the smartest doctor will likely do a
poor job without all the facts.

     One factor that does significantly differentiate doctors is the number of patients they see a day.   For
example, a primary care physician seeing thirty or more patients a day has little time to listen, make
thoughtful medical decisions, or explain what’s needed.  In contrast, a primary care doctor that sees 18
or fewer patients a day is more likely to provide a valuable service.

                                

        
Tell Me More about Concierge Physicians in Huntsville, Alabama.



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