Study: Doctors’ Concerns about Online Reviews May Be Unfounded

SPRINGFIELD — A new study in the Journal of General Internal Medicine has determined that, although the quality of online physician-review Web sites is generally low, physicians’ worries that such sites are smearing their reputations are largely unfounded.

In the health care quality community, public reporting is recognized as a key strategy in driving improvements in performance and patient outcomes. The study, undertaken by Dr. Tara Lagu and colleagues under the auspices of the Center for Quality of Care Research at Baystate Medical Center, is the first to systematically examine whether physician-review Web sites, which have proliferated amid a broader explosion of social-media use among consumers in general, contain inflammatory or potentially damaging information about physicians.

Its authors conclude that, even though 90{06cf2b9696b159f874511d23dbc893eb1ac83014175ed30550cfff22781411e5} of patient reviews on such sites are positive and, for the most part, doctors are not being harmed by anonymous posting of inflammatory, inaccurate, or damaging reviews, such sites have a ways to go before they will be effective tools for patients seeking guidance on choosing a doctor.

“This early snapshot seems to indicate that patients are almost uniformly positive about their physicians, and criticism is often constructive. But shortcomings in the quality and quantity of information provided, as well as significant use of paid advertisements, are presenting hurdles to patients who are seeking reliable recommendations,” said Lagu, a member of the Division of General Medicine and Geriatrics at Baystate Medical Center and an assistant professor at Tufts University School of Medicine.

The other study authors are Nicholas Hannon of the School of Public Health and Professional Degree Programs at Tufts University School of Medicine in Boston; and Drs. Michael Rothberg and Peter Lindenauer of the Center for Quality of Care Research at Baystate Medical Center and the Department of Medicine at Tufts University School of Medicine.

Physician-rating Web sites, such as Vitals.com, Healthgrades, and Angie’s List, allow patients to rate and discuss physician quality like travel Web sites allow guests to review restaurants and hotels. The National Health Service in Britain has encouraged patients to rate their physicians online, and the popularity of physician-rating websites is growing significantly in the U.S. But some physician organizations, including the American Medical Assoc., have opposed the development of these sites, claiming that patient identity cannot be confirmed, physicians will be unable to respond to negative comments because of confidentiality issues, and reviews will be excessively negative.

Indeed, at least one physician group has suggested that physicians make all patients sign a “gag order” stating they will not review their physicians online, when, in fact, patient reviews of physicians are positive more than 90{06cf2b9696b159f874511d23dbc893eb1ac83014175ed30550cfff22781411e5} of the time, according to the study.

“Patients remain unfamiliar with public reporting Web sites and do not routinely use publicly reported data to guide their choice of providers. Furthermore, some physicians are skeptical about the real benefits of these sites and their potential pitfalls,” said Lagu, who, with her colleagues, examined reviews of 300 physicians on 33 different physician-rating sites and found that, in addition to the positive tone of reviews, most criticism by patients such as “not enough parking” or “waiting too long” could be addressed without violating patient confidentiality.

The authors noted that the biggest hurdle to the widespread use of physician-rating Web sites is not the risk of negative or inflammatory physician reviews, but the poor quality of the sites. Reviews are relatively scarce, patients are unable to search by criteria that may be important to them, such as languages spoken by the physician, and most sites do not allow side-by-side comparisons of physicians. Many sites also have incomplete information about office locations and physician credentials.

The researchers also found in their study that most sites allow advertisements, and many promote health care products. Several sites allow physicians to purchase profiles, leading to a more prominent or positive display of that physician without revealing that these profiles are paid advertisements. One site offers an expensive gift in exchange for writing reviews on eight or more physicians. Also, a few extremely positive reviews seem to be written by physicians themselves, noted the study authors.

According to Lagu, the medical establishment’s concerns about physician-rating Web sites may be unfounded. “In light of these findings and the rapidly growing popularity of these sites, the medical community should encourage our patients to use and improve these sites,” she said.  “Professional organizations should also consider advising physicians to reveal conflicts of interest and to refrain from posting positive reviews about themselves.”