When it comes to finding a new doctor, it can be hard to know where to start. If you already have a primary care physician and are looking for a specialist, your regular doctor could give you a referral. You could check the phone book or ask friends and family for suggestions. But if you're like many people, the first place you'll go is to your computer, scouring the Internet for reviews and ratings.
Doctors' offices and hospitals have reviews and ratings, though many people still don't know it. About 65 percent of American adults are aware of online physician rating websites, according to a poll published this year in the Journal of the American Medical Association.
And few people ever write reviews. That same poll found that only 5 percent had ever reviewed a doctor online. According to an earlier report published in the Journal of Medical Internet Research, only 1 in 6 physicians had online ratings available by 2010. Still, the authors of that study contest that usage of online ratings is growing in popularity.
In the case of small businesses such as restaurants and shops, online reviews and ratings from past customers are all you need to assess quality. But is that true for hospitals and doctors? When it comes to medical care, there's a lot more to high-quality service than patient satisfaction alone. Here's what you should know about looking for doctors online.
What the Ratings Don't Tell You
The opinions of other patients are helpful to an extent, but they can leave facts out entirely. Reviews may be written after an unusually negative or positive experience, or based on factors outside the physician's control. Although many doctors claim online reviews can unfairly hurt a physician's reputation, most online reviews are positive.
In reality, these reviews may be more positive than the physicians deserve. Online ratings websites don't provide data such as medical and billing error rates, the number of patients with their diseases under control and the rate of unnecessary testing. Patients are giving a satisfaction rating, which may only reflect their happiness after an appointment. Therefore, if a doctor wants better reviews online, being nicer may go further to boost them than improving the quality of care.
"The ideal physician rating system would blend both subjective patient comments and reviews with objective quality measures," says Kevin Pho, an internal medicine physician and founder and editor of KevinMD.com.
He warns, as many physicians do, that subjective patient comments do not always accurately portray the quality of physicians. "Sometimes giving patients what they want, like unnecessary antibiotics, isn't always what's best for patients," Pho says.
In that sense, online reviews "are often indicative of doctors who acquiesce to patient requests to boost their ratings," he adds.
Offline Reviews Aren't More Reliable
According to a 2012 study published in JAMA that looked at nearly 52,000 privately administered patient surveys, the most satisfied patients fared worse in many ways. Even though highly satisfied patients used fewer emergency services, they spent more on prescription drugs and medical testing and had increased mortality rates.
Offline rating systems provide further insight to the perils of subjective ratings. Health systems, insurers and Medicare are using rating systems more frequently to determine payment and reimbursement for doctors. This can result in the over-ordering of tests and drugs, including potentially addictive drugs. In an open letter to Marilyn Tavenner, the administrator of the Center for Medicare and Medicaid Services, two senators expressed their concern that Medicare's use of patient satisfaction ratings may be unintentionally encouraging opioid addiction.
U.S. Sens. Dianne Feinstein, D-California, and Charles Grassley, R-Iowa, wrote in June 2014 that "some practitioners reported that they have prescribed opioids for the specific purpose of improving their patient satisfaction survey scores." They went on to detail how one hospital even handed out Vicodin "goody bags" to improve scores.
When Reviews are Helpful
Although an online review won't tell you much about a doctor's track record, it can clue you in to one important factor: bedside manner. A doctor's attitude plays a big part in the patient-doctor relationship and is key to maintaining trust, because you're more likely to lie to a doctor you don't trust. Even a great doctor can't do a good job protecting patients' health without all the facts.
Online reviews also give insight to issues such as wait times and punctuality and correlate weakly with quality, research suggests. Those studies are limited, however, by the small number of ratings available for each doctor, allowing them to be easily skewed. Ratings may have less to do with the doctor and more to do with the support staff or clinic employing the doctor. Still, they're important. Your time is valuable, and you probably don't want to waste too much time waiting for one doctor if you have other high-quality options in your area.
What to Keep in Mind When Searching
If you're on the hunt for a new doctor, whether be it a specialist or primary care physician, remember that all reviews are subjective. That includes recommendations from friends and family members, who may look for different qualities in a doctor than you need. "Blending objective measures with patient reviews would provide a more accurate, thorough evaluation of physicians. We are not yet there," Pho says.
Still, some online review sites are gradually improving. Healthgrades.com takes into account a doctor's board certifications and the affiliated hospital quality metrics, including awards. Physician location and rating website BetterDoctor.com shows the most commonly performed services by a doctor, as well as costs, insurance plans accepted and patient reviews.
The health insurance plans any prospective doctor takes should be key in your decision. After all, health insurance does you no good if you don't use it, starting with making sure it covers your doctors. Most doctors are qualified and competent and will treat you to the best of their abilities if given the chance.