Doctor Ratings and Reviews Websites: A Fair Representation of Patient Experiences?
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As consumers, we rely on ratings and reviews to get the best deals for cameras, TVs, refrigerators, plumbers, contractors, restaurants, you name it. So it should come as no surprise to find doctors added to the list. At last count, some 40 websites rated doctors, but the usefulness and legitimacy of these sites are still an open question.
Doctor Ratings and Reviews: Patients Can Post with Impunity
Most of these doctor ratings and doctor reviews sites allow anonymous posting, which is great for those who want to vent with impunity, but not so great for physicians whose reputations are on the line. Though most postings are positive, one derogatory posting can damage a hard-earned reputation, and no rules or ethics require an anonymous poster to be truthful or fair. As you might surmise, anonymous posters don’t even need to be patients; it could be a competitor or merely someone with a grudge.
In many other situations, people can respond to criticism. But physicians cannot, as they are bound by professional ethics and by privacy laws. And, under law, web sites are immune from accountability for what is posted. It is the policy of many sites not to monitor or remove postings. The case of doctor ratings thus presents an unfair distortion of freedom of speech: internet users are free to criticize doctors, but doctors cannot respond to those criticisms.
Legitimate Consumer Feedback or Useless Information?
Proponents see the physician rating websites as a legitimate form of consumer feedback, and maintain that patients have the right to express their opinions about the expensive services they have received. Proponents also claim that the websites perform a service to doctors themselves, who can learn how to improve their care by finding out what really irks patients—things like long waits, unfriendly office staff, or doctors who don’t listen.
But rating a physician is not the same as rating a car or a plumber. Car ratings are based on expert and objective assessments, plumber ratings on the quality and cost of the fix. Physician ratings, on the other hand, are subjective and may have nothing to do with the quality of care. A physician who prescribes what the patient wants may get a glowing review, while a physician who won’t prescribe a drug unnecessarily can get slammed.
Some say the information on the physician rating sites is too limited to be of any use. A few comments from a handful of grateful or disgruntled patients says nothing about the quality of care, training, credentials, or any of the other criteria people use when picking a physician. Some sites don’t even have such basics as an address, while the information presented on other sites is out-of-date. As one analyst points out, the few users who do post tend to be the extremes—either the grateful or the dissatisfied—and when most physicians see hundreds of patients, a handful of comments lends no statistical validation to the ratings.
Physicians Fight Back
Critics also call the sites defamatory and flawed. But a bigger problem for physicians is the anonymous postings, which may not even come from legitimate patients. Medical Justice, a group started by a physician to address frivolous malpractice suits and Internet defamation, encourages member physicians to enter an agreement with patients that offers additional privacy protections in return for providing valid feedback, but only on sites that meet certain standards of fairness and verification that the poster actually is a patient.
Medical Justice has been accused of censorship, and of denying patients their right to freedom of speech, charges the group denies. According to Medical Justice, the agreements are not “gag orders,” as some have charged, but are “a solution that balances the rights and expectations of patients with the concerns of doctors.”
Better Ranking Sites Are Needed
A number of groups are trying to improve online rankings, among them Consumers’ Checkbook. Working with several major insurers in a pilot project, Consumers’ Checkbook surveyed members about their doctors, using questions developed by the government’s Agency for Healthcare Research and Quality. Ratings will be posted only if a doctor gets a significant number of responses, and doctors can review their results before public posting. So far, however, only a few cities are involved.
For now, doctor ratings sites should be viewed with skepticism, but with some time and adjustments, the online sites can provide a valuable service to both doctors and patients. Constructive feedback will help doctors provide better care, and with more accurate information, patients will make better choices. After all, patients only want doctors who care, who will listen, and who know what they are doing. Whether this positive evolution of the doctor ratings sites actually happens, however, remains to be seen.