In the 21st century virtually everything is subject to online reviews. While these opinions can be helpful in determining the next car or television you purchase, there is considerably more at stake when you choose a physician. If you are looking merely at the number of stars a physician has on sites like Ratemds.com or Healthgrades.com, you may be missing out on a medical expert who has provided decades of exceptional care. Like any profession, there are physicians who are less successful than others, but when determining the type of care you and your family are likely to receive, a one to five star rating system is hardly the most insightful and comprehensive way of measuring competency. Before you entrust you and your family’s health with a new physician, it is in your best interest to understand how those opinion surveys work. A 2008 Wall Street Journal poll found that 91% of consumers prefer having online information about physicians through their insurer and 87% would like to know what others thought of them. This is not surprising given the prevalence of online survey information. Consumers expect products and services to list the reviews of past purchasers, so if physicians failed to have reviews beneath their names it would be surprising. What you should understand about these ratings systems are their inherent flaws. First of all, this is not a ratings system with a large cross section of patients treated by the physician. Inevitably, the population of reviewers is composed of two types of patients: the immensely appreciative and the utterly dissatisfied. Patients who enjoyed competent care typically do not write reviews or rate physicians because they received what they expected, leaving only the most extreme groups to express their gratitude or displeasure. This inevitably produces two distinct types of reviews. On the one hand, some review sites produce extremely positive ratings, while others lean towards the critical. In many instances, this can be a product of merely statistical distribution, but you should also be aware that many physicians encourage patients to post their experiences on certain sites. This inevitably yields an overwhelmingly positive online reputation for the reviewed physician and the overall profession—after all, a consistently poor physician would likely have few patients, and therefore contribute fewer negative reviews to the overall entire pool of responses. This bears out in a study by Lagu T, et al, which found that almost 88% of all online physician reviews were positive. With this abundance of support for most physicians, should reviews be used at all? Of course, but primarily as a meta-critical resource. Looking at a single, or, even, three ratings sites can produce a distorted image of a physician’s competency. One or more of these sites can be skewed by a single disgruntled patient (or even, non-patient). If you would like to obtain a more comprehensive snapshot of a physician, you should examine his ratings and reviews across multiple sites. Unfortunately, the psychology of the consumer plays an important role in something as subjective as “quality of patient care.” In the vast majority of patient/doctor interactions, the doctor provides more than a modicum of quality care. This may not be sufficient for many patients, however. They may judge the visit based on relatively, unimportant aspects such as wait time, responsiveness to concerns, time devoted to discussion, or bedside manner (these may be priorities to the patient, but minimally influential on the care quality). In the current medical environment where the doctor’s time is at a premium, many of these aspects of patient interaction may be sacrificed without serious detriment to the standard of healthcare. According to a 2014 poll by the Associated Press, only 22% of respondents were confident they could evaluate the ability of a physician, which begs the question: how to know which physicians to avoid? If you are trying to weed out potential bad apples, there are some ways to do so using online ratings. Consistently bad ratings and reviews across the spectrum of ratings sites should raise some flags. You may wish to investigate whether this particular physician is board certified (a benchmark for expertise) or if they have been sued or censured for malpractice by checking with the state medical board—some states do not make this available—or the Federation of State Medical Boards. Ultimately, the use of physician ratings is a risk. In general, most practicing physicians are quite competent and likely to provide a high level of care. A poor rating may disqualify a highly qualified caregiver with less than outstanding bedside manner, while a five star rating may subject you to a likable physician with less than ideal medical skills.
Written by: Robert Moghim, M.D., CEO- Moghim Medical Consulting Inc.