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Don't Let Billing Drag Down Your Patient Ratings

Analysis  |  By Alexandra Wilson Pecci  
   July 18, 2018

Negative online comments and scores about spine surgeons were more likely to fall under 'surgeon-independent' factors like billing in a new study.

Spine surgeons earn high ratings for their skill and clinical outcomes on internet review sites, but are more likely to receive negative ratings and comments on factors pertaining to clinic staff, billing, and wait times, reports a study in the journal Spine.

"Online review scores for individual surgeons are not just based on surgical outcomes and bedside manner," lead author Chester "Chet" John Donnally III, MD, tells HealthLeaders Media via email.

"While these are by far the most important factors for providing great healthcare, other variables such as the greeting from the front desk nursing staff, friendliness of the surgical scheduler, and transparency in billing are all factors that patients value and will write reviews about," he says.

Researchers analyzed the patient ratings of 210 Florida spine surgeons from three physician rating websites: Healthgrades, Vitals, and Google.

Approximately 90% of the comments were classified as relating to the surgeon's competence or surgical outcomes (type 1) or the surgeon's character and communication ability (type 2). In these areas, ratings were highly positive.

The remaining 10% of comments were related to "surgeon-independent" factors, such as the office staff, office environment, or billing (type 3). Most ratings for these factors were also positive: About 57% of type 3 ratings were four or five stars on Vitals, with a similar pattern for the other sites. However, negative comments and scores were more likely to fall under type 3 than under the other types.

"Online review scores with comments pertaining to surgeon-independent factors (type 3 comments) were significantly lower than scores that pertained to surgeon-dependent factors, such as treatment outcomes and physician character," Donnally says.

The percentage of one-star ratings for type 3 comments was 33% on Vitals, 28% on Healthgrades, and 20% on Google. Upon statistical analysis, ratings for these type 3 comments averaged about two to 2.5 "stars" lower than for type 1 comments.

Donnally says that ultimately physicians aren’t responsible for billing and cost ratings.

"Most healthcare providers do not know how much clinic visits or surgical procedures actually cost, and they are not to blame as these figures are extremely variable and depend on [the] insurance provider," he says. "Factors such as costs and billing are usually not determined by the physician."

Still, it's critical that everyone—from physicians to the front office staff to the billing department—be aware of their impact on patient ratings and reviews. 

"In a profession that relies on referrals, it is imperative that the entire team works together to maximize patient satisfaction," Donnally says.

Alexandra Wilson Pecci is an editor for HealthLeaders.

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