Fall 2014
Online physician ratings: Approach with caution

synapse: University of Nevada, Reno School of Medicine

Dr. Pasternak

Family physician

Pasternak cautions fellow physicians and patients about medical review sites. Photo courtesy of Andy Pasternak.

Story by Andy Pasternak, M.D.

For practicing physicians, the rise of the Internet has resulted in many benefits while simultaneously giving rise to new drawbacks. Internet-based physician review sites are a prime example. The web has given anyone with access to a computer or smart phone a forum to voice their opinions. In the travel and restaurant industries, well-established online review websites with large numbers of reviews help customers by giving them more up-to-date recommendations than traditional print books. In the same way that people can review the hotel they stayed at or the restaurant they ate at last night, now, patients can similarly review physicians, hospitals and the medical industry in public forums.

While there may be some potential benefits, medicine has particular issues compared to other service industries, raising very interesting questions.

Websites posting physician reviews

Both generic service industry websites, for example, Angie's List, Yahoo! and others, and more health care specific websites are battling to become the dominant website for people to use when researching their physician. Each of these websites has their own particular methodology for capturing the patient's review. Some websites have specific rating systems while others rely more on open-ended comments from patients. In some cases, the differences in methodology could paint very different pictures of the same provider.

Issues specific to medicine

Unlike the restaurant or hotel industry where a few websites have matured and dominate the market, no one particular physician Internet review site currently fills this role. Instead, patients have a plethora of websites they can access to review providers. This, in turn, dilutes the number of reviews for any one provider on a specific site. One website might have only a glowing review, while another website might have a scathing comment on the same doctor. Because of this, it's often difficult to get an accurate picture of the physician, clinic or hospital from a single online source.

While health care is a certainly a service industry, practicing medicine is fundamentally different from other service industries. One major issue is that the patient's opinion of their care may or may not actually reflect the quality of care that was provided. While medicine is making strides to create a more patient-centered system, there may be specific times where patients may have unrealistic expectations or make undue demands of their physicians.

For example, patients may request medications from their physician that may not be medically necessary such as narcotic pain medications, other controlled prescriptions, or performance enhancing medications. Other times, patients may insist on unnecessary tests or procedures. Finally, if patients and their families get unfortunate news, it could affect how they review that particular provider or hospital in spite of the physician providing high quality care.

Within the medical community, physicians debate how much they need to monitor and address website reviews of their practice. There is also quite a bit of variance of how much practices encourage their patients to review them online. Providers who offer elective care such as plastic surgeons or cosmetic dermatologists tend to be more aware of their online profile than physicians who provide services where the patient has less of a choice of who will provide care for them. Due to privacy issues, physicians also can't respond specifically to a bad review as a restaurant owner or hotel manager is able.

It is critical for patients to understand all of these issues if and when they use physician rating websites and to take these reviews with a grain of salt. Old fashioned word-of-mouth from friends and family or asking a physician with whom you already have an established relationship still may be the best way to pick your next provider.