Turning Online Physician Ratings into Lemonade

Elyas Bakhtiari, for HealthLeaders Media, June 26, 2008

Every time I open a newspaper or visit a major Web site lately, I see another article about the emergence of online portals that allow patients to rate their physicians. And the recent barrage of media coverage seems to have left many doctors skeptical of the unregulated sites and worried about their potential consequences.

Although perhaps overhyped in the media, many of their concerns are real. A few patients have already used negative online ratings as a form of "vigilante justice" when a malpractice lawsuit or complaint to the medical board didn't do the trick. And the anonymous format of many sites raises questions about whether patients will be honest (and whether it will only be patients leaving feedback).

Facing this reality, physicians have three options.

They can ignore the emerging trend and hope it doesn't affect their practices. This is feasible for now, but new companies are getting into the physician-rating business every day (Angie's List and Zagat, for example), and the influence of the sites is growing. Twenty-two percent of respondents to a recent poll by the California HealthCare Foundation reported looking at physician rating sites in 2007, up from 14% in 2004.

Eventually, physicians will have to accept online ratings as a normal part of practicing medicine.

The second option is resistance. Some practices are considering requiring patients to sign a contract in which they promise not to post any comments online without their physician's approval. The concept was developed by Medical Justice, a group dedicated to preventing frivolous malpractice lawsuits.

Not only is the legality of this approach questionable, but it can't be good for patient satisfaction. I agree that frivolous lawsuits are a major problem for physicians, but as a healthcare consumer, I wouldn't return to a physician who presented a gag order before the visit.

The third option—and best, in my opinion—is to use online ratings to improve your practice, to take the potential bag of lemons presented by physician rating Web sites and make lemonade.

For example, Jeanine Brailey, a practice administrator with Queen City ENT Associates in Cincinnati, was able to use online patient ratings to negotiate a 3% discount in each physician's malpractice fees.

The office had initially evaluated a number of paper surveys to measure patient satisfaction, but it decided instead to direct patients to Cincinnati.md—a physician rating Web site operated by YourCity.md—and monitor the feedback. When the group's malpractice carrier offered a discount if the group could show that, among other things, it was soliciting patient feedback and complaints, Brailey was able to point to the online rating system to negotiate a better rate.

Mark Deutsch, MD, an otolaryngologist with the group, says actively monitoring patient comments on the site has also led to improvements around the office, as well as a few new patients who first read about his service online.

Rating Web sites are still a long way from becoming an integral part of the healthcare process—only about 2% of patients have actually changed physicians based on information from an online rating, according to the California poll.

But most practices want and need patient feedback, and online rating sites provide that. Although there are certain risks involved, savvy practices will see them not as a threat, but as a new tool for managing the practice and improving patient care.

Elyas Bakhtiari is a managing editor with HealthLeaders Media. He can be reached at ebakhtiari@healthleadersmedia.com.
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