The Apex

If you asked the average American when they last searched online for customer reviews of a product or service, they would probably say “within the past few days.” Internet reviews have become ubiquitous for almost everything that we purchase. Google a local restaurant, hotel, barber, bike shop, or hardware store, and instantaneously, you will see a map, photos and customer reviews. Dig further on popular sites such as Yelp, Amazon, TripAdvisor, or Angie’s List and you will find additional detailed feedback such as quality, value, location, durability, satisfaction, etc.

But what about reviews for medical care? What sites exist and how reliable are they?

Last year, I needed an orthopedist to evaluate my left foot that I had injured while running. Like most people, I first checked my insurer’s website for in-network physicians and created a short-list of providers. I then searched each physician online and found some basic information (through a variety of websites), including where they went to medical school and did residency training; clinical areas of expertise; number of years in practice; etc. In some cases, I found patient reviews but not many (maximum three or four per physician). The process was moderately helpful, but unsatisfying. It was time consuming, inefficient, and not as informative as when I search for other things … like restaurants in Manhattan.

My experience is not unusual. Recent studies in the Journal of American Medical Association (JAMA) have found that while 60% of consumers use online reviews to choose new healthcare providers, most sites do not offer enough data to be useful to consumers.[1] The specific limitations include: (a) limited quantity of reviews (one third of doctors in the study had no reviews and most of the rest had one review); (b) no cross-referencing between physician medical records and state medical boards; and (c) cumbersome search mechanisms.

Physicians also have expressed concern about review and rating sites that exist online today. They say that medical care – unlike choosing a barber or dry cleaner – is very complex and there are numerous factors outside of their control, such as large insurer invoices that may lead to a bad review. Moreover, online rating sites typically do not take into account quality and outcome measures, such as the Physician Quality Reporting System (PQRS) or National Surgical Quality Improvement Program (NSQIP), promoted by the Centers for Medicare & Medicaid Services (CMS).

Notwithstanding these concerns, it is clear that rapid advances in technology are facilitating an ever-increasing flow of information that consumers rely upon to make choices. So while physician review sites have yet to reach optimal levels of accuracy and reliability, they are here to stay and will continue to improve. Some of the leaders in this space include:

• Zocdoc – Main feature is appointment scheduling, but their searchable database includes clinical specialties, insurance information, office locations, provider photos, educational background and user-submitted reviews.
• Yelp – Most widely known for dining options, Yelp also has a section dedicated to medical providers. They are featured in Apple Maps searches, which broadens their reach in mobile searches. In addition to patient reviews, search results include office location, hours, telephone number, and website.
• WebMD – One of the older search tools (started in 1996), WebMD is known primarily for information on medical symptoms but they also offer physician profiles, with information such as the number of years in practice, clinical specialties, ratings and insurance.
• Other leading sites include RateMDs, Healthgrades, Google Reviews, Care Dash, and Angie’s List.

Transparency and free flow of information enabled by digital technology is a reality of the world we live in. Consumers will continue to demand (and drive) feedback mechanisms, which will put pressure on review sites to improve their technology and reliability. Physicians will need to proactively manage their online reputations by becoming their own brand ambassadors, using strategies such as: (a) mining the Internet for patient reviews and comments; (b) tracking review sites in a central database; (c) addressing negative comments immediately; (d) creating patient surveys and requesting feedback from patients shortly after the interaction; and e) hiring online reputation management companies. Over time, I believe these forces will help improve the reliability and accuracy of physician review sites.

Footnotes:

[1] Lagu T, Metayer K, Moran M, Ortiz L, Priya A, Goff SL, Lindenauer PK. Website Characteristics and Physician Reviews on Commercial Physician-Rating Websites. JAMA. 2017;317(7):766–768.