June 16, 2010

Rate My Doctor

Online reviews of physicians are more positive and less plentiful than expected, study finds

By Taylor McNeil

With the proliferation of online customer reviews of everything from restaurants to roofers, it was inevitable that doctors would face the scrutiny of their patients, too. Some physician groups have been none too happy at the prospect, though, fearful that reviews would be negative and damaging to their reputations.

But a recent study found that doctors may not have as much to worry about as they think, and might even learn something about how their practices serve their patients. The study, led by Tara Lagu, an assistant professor at Tufts Medical School and an internist and researcher with the Center for Quality of Care Research at Baystate Medical Center in Springfield, Mass., found that online reviews of doctors were overwhelmingly positive and that there were far fewer of them than physician groups had anticipated.

“We found that the sites are not being used as much as we thought they would be,” says Lagu. “There was a lot of hype among physician groups in the last couple of years that there would be a lot of negative reviews, that patients would be saying things on these sites that would be potentially damaging to doctors’ reputations and cause real problems for them.”

Using 33 national websites that provide doctor ratings, Lagu and her colleagues searched for reviews of 300 randomly selected Boston physicians. They found 190 reviews of 81 of the doctors, and of those, 88 percent of reviews were positive, 6 percent neutral and 6 percent negative.

By comparison, they did an online search for restaurants in the Beacon Hill area of Boston and turned up 38 narrative reviews for a single Lebanese restaurant. “Clearly this hasn’t picked up with patients in the same ways that restaurant reviews have picked up,” Lagu says. “Maybe it’s because it’s an early snapshot.”

The preponderance of positive reviews might be due to the more personal relationships that develop between doctors and patients, Lagu says. “You may get your roof redone, and it would never cross your mind to write a review if your roof didn’t leak for 20 years. But if your roof leaked [shortly after it was installed], you’d be much more motivated to write a negative review,” she says. “But if a doctor cures your cancer, you may think about that every day for the rest of your life, which could explain why more doctor reviews are positive. When we make a positive impact, it may have a longer-lasting effect.”

Even negative reviews might be helpful to doctors. A few complained about things like parking and office wait times—aspects of their practice that some doctors might not consider since it doesn’t involve direct patient care. “We have to really remember that all the things that our patients see—our staff, the office, the parking—it’s all us,” Lagu says. “We as doctors tend to get tunnel vision in a big way, and think, ‘If I’m late, that doesn’t have anything to do with my relationship with my patients.’ We need to remember that it is all us.”

The study, which was co-authored by Tufts graduate student Nicholas Hannon and published online in the Journal of General Internal Medicine in May, also found that a small number of reviews seem to have been written by the doctor in question “or by an agent of that physician.” The tip-offs were obvious: descriptions of academic appointments, publications in medical journals and the like. The vast majority of reviews, though, seemed legitimate.

The takeaway, says Lagu, is that these websites are “growing and developing and have a lot of potential. The evidence does not support fighting this development. Rather, I think it makes sense for us to think about how we might help improve the sites by encouraging sites to allow for doctors to reply to comments and to improve usability for patients.”

Taylor McNeil can be reached at taylor.mcneil@tufts.edu.

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