Surprisingly, poor physician ratings posted online are not the result of angry patients or professional rivals, a researcher says. Instead, the numbers are often skewed because of low numbers of reviews.
Hospital marketing departments and physicians practices like to see their doctors get positive reviews on consumer websites, and online ratings are popular with consumers. One-third of consumers in the United States who consulted physician website ratings reported selecting or avoiding physicians based on those ratings.
But there is no correlation between online patient ratings and clinical quality, according to a study published in JAMA Internal Medicine.
"Our study is important because it is one of only a handful of studies to examine the ability of physician website ratings to reflect the quality of care patients are likely to receive," says lead author Bradley Gray, PhD.
"We found that 60% of physicians are rated online—and that number is growing," Gray said by phone last week. He makes it clear that while he feels websites provide consumers with some valuable information, such as whether or not physicians are board certified, the rating systems can be a distraction and scores tend to be "completely random."
The study looked at 1,299 physicians who completed an ABIM Patient Experience Practice Improvement Module in diabetes or hypertension between July 2001 and November 2012. Researchers compared patient survey responses and chart abstractions against physician ratings on eight popular health-based websites which were selected based on Google searches of each participating physician's name, city, and specialty.
Gray and his team found no evidence that physician website ratings were associated with clinical quality measures.
Results indicated that physicians with poor website ratings of one-out-of-five stars received ratings of very good or excellent in hospital-provided surveys from 79% of patients—a number similar to physicians with a five-star website rating, who received ratings of very good or excellent from 82% of patients.
Linked-Out
Poor physician ratings are not the result of malicious trolling by angry patients or vengeful rivals, a finding Gray calls "surprising."
"We found no evidence that the web ratings were somehow reflecting antagonistic consumers. They seemed very random… We initially thought we might find that, but we didn't really."
He and his team had hypothesized that lackluster scores might be a result of more angry consumers leaving negative reviews than satisfied consumers leaving positive reviews, but that did not bear out to be true, either.
Instead, Gray says, the numbers are often skewed because of low numbers of reviews, which makes them unreliable and statistically insignificant. "We found a median of [a total of] four ratings per physician, which is not a high enough number for there to be any scientific rigor."
The researchers' findings suggest that hospital leaders should not be overly concerned about physicians receiving poor scores on consumer website, especially if their HCAHPS and patient satisfaction surveys are positive.
But the findings should also not diminish the importance of patient feedback, explains Gray. "There is very good evidence that patients provide important information on quality of care, and patient feedback is an important piece of provider care quality—but the web reviews are not a good source of information about that."
More Data to Come
To remedy this problem in the future, Gray recommends using board certification as a quality standard consumers can trust, as it is a rigorous process directly related to quality of care.
Unfortunately, there is little recourse for physicians with damaged online reputations. In such cases Gray advises sharing board certification data with patients and strong patient survey scores with wary employers.
More accurate quality information may be available soon-- beginning January 1, the Centers for Medicaid & Medicare Services will be update its Physician Compare website with more objective data on physician quality. Additional data is planned for release in 2016.
In the meantime, "the results of our study should make consumers think twice about relying only on these website ratings as a source of quality information. This study also highlights the need for more valid and reliable physician quality information to be made publicly available," says Gray.
Lena J. Weiner is an associate editor at HealthLeaders Media.