Doctors Check Online Ratings From Patients and Make Changes

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by Sumathi Reddy, May 19, 2014

It’s one of the most important services we pick, yet more people are turning to online reviews to pick doctors. Sumathi Reddy reports on Lunch Break with Tanya Rivero.

To find a good restaurant, we can check any number of online reviews.

To select a doctor, however, many of us rely on a single recommendation, or even a random search through the Yellow Pages. A growing number of doctor-review websites are aiming to change that by allowing people to rate physicians in much the same way they would a sushi dinner or haircut.

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Better Listener

Dr. Andrew Pasternak, a family physician in Reno, Nev., says he engages more with his patients since reading criticisms online that he spent too much time jotting notes in his tablet computer.”It is a truly a three-way conversation, with the doctor and his PDA taking center stage,” wrote one patient on RateMDs.com.”I have to admit it’s a bad habit that I’ve been working on over the past year or two,” says Dr. Pasternak.Patients noticed the difference. In a later comment on RateMDs.com, another patient wrote: “His attentiveness has improved markedly and, although the tablet is still there, it doesn’t dominate the appointment.”

Experts say there some 40 to 50 online sites that include doctor reviews or ratings. The three big ones—Healthgrades, RateMDs.com and Vitals—all say they are seeing significant growth in terms of number of reviews and unique visitors.

About 25% of U.S. adults consulted online physician-rating sites, and more than a third of them went to a physician or avoided one based on the ratings, according to a recent study by researchers at the University of Michigan and published in the Journal of the American Medical Association. Only a few of the 2,000 people surveyed for the study said they had written online reviews.

Many doctors remain wary of online reviews, concerned that negative comments can damage their reputation. Being a good doctor can sometimes mean giving patients hard advice. And some doctors fear comments from disgruntled patients or ex-employees could drive other patients away.

Some reviews “can be pretty brutal,” says Andrew Pasternak, a family physician in Reno, Nev. However, he says, “part of being a physician now is having to deal with these.”

Online reviews were discussed at this month’s national convention of the American Psychiatric Association. A workshop entitled “Are You a Sitting Duck Online?” talked about how negative reviews can affect the psychiatrist-patient relationship. The effects of negative reviews also came up at a social-media talk at the American Congress of Obstetricians and Gynecologists national convention in April.

Dan Bauhaus says multiple job changes have forced him to look often for new doctors for himself, his wife and their four children. He says he researches doctors using Yelp and any other sites that pop up on an Internet search.

“If no one is reviewing them…then I don’t feel like they are keeping up with the times, which says something about them,” says Mr. Bauhaus, a 50-year-old software salesman in San Carlos, Calif.

Mr. Bauhaus says most reviews are helpful. “The ones that are negative I always take with a grain of salt,” he says. “But if there’s a bunch of negative reviews, then OK, maybe something’s going on.”

Some physicians encourage patients, especially those satisfied with their services, to post online reviews by leaving fliers or brochures in the waiting room or a request on their websites.

“I think there’s still sort of a bias toward a lot of really negative reviews,” says Dr. Pasternak, the Reno physician. In one review, a patient wrote that Dr. Pasternak didn’t like children. The doctor said the patient had brought four children to the appointment and “I was trying to talk to her about this sensitive personal issue and it was just very difficult.”

Some reviews are constructive. When a patient noted on an online site that Dr. Pasternak was spending too much time jotting notes on his tablet computer, he says he made an effort to make better eye contact and appear more attentive.

A study in the Journal of Medical Internet Research found that online reviews were overall positive, with nearly half of the physicians getting a perfect ranking. “We found quite a striking difference between what physicians perceive about their ratings and what patients actually say about their doctors,” says Guodong (Gordon) Gao, a professor of information systems at the University of Maryland and lead author of the 2012 study.

In another study currently being reviewed for publication, Dr. Gao and Ritu Agarwal, co-directors of the Center for Health Information and Decision Systems, suggest online reviews are generally reliable indicators of patients’ opinions.

The researchers looked at 1,425 family-practice physicians in three metropolitan areas. Of these, nearly 800 had ratings at online site RateMDs.com. An outside company then surveyed more than 100 patients from each doctor’s office using a standardized government questionnaire to rate impressions of physician quality.

The two sets of results mostly reflected each other.

“There’s a fairly high correlation between the online quality measure and the true quality measure,” says Dr. Agarwal.

Gregg DeNicola, chief executive of Caduceus Medical, a 20-doctor family-medicine practice in Orange County, Calif., says his first dealings with online reviews were almost all negative. Fired employers who posted fake reviews, he says, and patients who wanted Vicodin when they didn’t need it and vented online.

“First we did what anyone would do, we just ignored it,” says Dr. DeNicola. “Then new patients were actually canceling appointments because of reviews and we realized this could be more serious than we thought,” he says.

The practice decided to embrace online reviews. Its website asks patients to relate their experience. Staff members contact patients who have positive things to say, or who respond positively to in-office surveys, and invite them to comment on sites that include reviews of doctors, such as Yelp.

Staff at Dr. DeNicola’s practice monitor review sites daily and respond to negative reviews. Commenters are invited to contact the office about their problem.

Dr. DeNicola says new patients are now coming to the practice because of positive online reviews, particularly with many people newly insured through the Affordable Care Act. The review sites are “helping us a lot,” he says. “When we decided to quit ignoring it and embraced it, it totally changed the game.”

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The Wall Street Journal:

http://online.wsj.com/news/article_email/SB10001424052702304422704579571940584035918-lMyQjAxMTA0MDIwMjEyNDIyWj

Write to Sumathi Reddy at sumathi.reddy@wsj.com

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