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Physician Review Sites List Inconsistent Patient Satisfaction

New research shows that different physician review sites show varying degrees of patient satisfaction, calling into question their validity.

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- A new study shows that ratings on different physician review websites often paint inconsistent pictures of patient satisfaction.

Researchers from the Hospital for Special Surgery (HSS) presented their findings at this week’s American Academy of Orthopaedic Surgeons Annual Meeting, showing that clinician reviews are inconsistent across Healthgrades, Vitals, and Ratemds, three popular physician review websites.

The team looked at online profiles for 275 sports medicine specialists rated on each of the three tested websites. Researchers took notes on clinicians’ years in practice, location, and academic affiliation. The researchers then categorized qualitative comments as clinician competence, affability, and the process of care delivery, three areas which the researchers said define positive patient experiences.

"Historically, three key qualities – affability, availability and ability, known as the ‘three As’ – have been suggested to promote a successful surgical career and favorable interactions with patients,” said Anil Ranawat, MD, one of the presenters and lead researchers.

Ranawat and his colleague, Benedict Nwachukwu, MD, MBA, saw negligible correlation between individual physician ratings across the three tested physician review websites. Clinicians may have had a high rating on Ratemds, but a low rating on Healthgrades or Vitals.

These inconsistencies may be due to a low volume of reviews on each individual website, Ranawat and Nwachukwu said. A clinician with excellent reviews on Vitals may have gotten only one scathing review on Healthgrades, marring the average rating on that specific website, for example.

The researchers noted that more investigation should go into determining the ideal number of reviews necessary to constitute a credible average rating score.

The researchers did identify some common characteristics that affected clinician scores. Female surgeons and surgeons with an academic affiliation tended to have higher satisfaction scores than their male or non-academic affiliated counterparts.

Online presence – such as Twitter or Facebook profiles and personal websites – did not appear to have any influence on provider ratings. Additionally, increased number of years in practice tended to yield lower provider ratings across all three websites, a finding that surprised Ranawat and Nwachukwu.

The tested quality determinants – competence, affability, and process of care delivery – only had influence on clinician scores for the highest and lowest ratings. Perceived clinician competence and communication skills did not affect average ratings.

"Surgeons with the highest and lowest ratings were significantly more likely to receive comments about their competence or affability," stated Nwachukwu. "As such, it appears that even in the modern era, and with the adoption of online rating mechanisms, the traditional three As of ‘availability, affability and ability’ still hold sway."

These findings are notable considering the increasing popularity of clinician review websites.

"Consumer-driven healthcare and an increasing emphasis on quality metrics have encouraged patient engagement in the rating of healthcare,” Nwachukwu pointed out. “As such, online physician rating websites have become mainstream and may play a potential role in future healthcare policy.”

However, Ranawat noted that limited consistency between ratings websites are an issue, showing that online patient satisfaction websites may have limited validity.

“The low degree of correlation between these websites is concerning,” he said. “It also questions the collective utility of these sites and potentially demonstrates the individually capricious nature of online physician reviews."

Despite these concerns, the researchers acknowledged that online clinician reviews can serve as a lens into patient satisfaction, and can inform healthcare providers and policymakers in patient priorities.

"Although it is debatable whether these websites in their current form truly capture patient satisfaction and objectively evaluate the delivery of care, they represent a potential tool for both payers and healthcare systems to gauge how surgeons are assessed by their patients," said Ranawat.

More research is necessary to fully understand the effect physician review websites have on provider selection, patient experience, and clinician workflow improvements. Additionally, experts should investigate strategies for making physician review websites more credible.

"An understanding of the factors that influence online physician ratings may have important implications for sports medicine surgeons, and for physicians in other specialties, as well," Nwachukwu concluded. "Perhaps more attention should be paid to improving the validity of online ratings for assessing quality and the outcome of care provided."