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Correlation of Online Physician Reviews and Overall Patient Satisfaction

      Until recently, health care decision makers needing to expand or replace members of their clinical teams made these decisions on the basis of recommendations of their existing health care professionals, word-of-mouth reviews in their communities, and the availability and proximity of clinicians in their region. As connectivity to the Internet has expanded, online review services have proliferated, and medicine has been included with virtually all service-oriented fields. As with choosing a restaurant or hotel, modern health care consumers need to consider the value and findings of online reviews of their health care teams when making decisions. Availability of reliable data regarding an individual physician's or organization's outcomes, professionalism, timeliness, cost, access, and other issues will likely be increasingly important as patients contribute more of their own financial resources to their health maintenance and care. Patients and the health care industry need to understand the use and impact of online reviews on decision making as well as the value of the information provided.
      Amante et al
      • Amante D.J.
      • Hogan T.P.
      • Pagoto S.L.
      • English T.M.
      • Lapane K.L.
      Access to care and use of the Internet to search for health information: results from the US National Health Interview Survey.
      reported survey data in 2015 on more than 30,000 health care consumers regarding access and sources of information. They reported that 44% searched the Internet for health information, and 4% visited online health chat rooms. Women were 1.5 times more likely to use online sources than men, and online use was more common among younger respondents and those with more education. Furthermore, this study found that use of online resources was significantly higher in individuals who had experienced access issues or had a higher Charlson Comorbidity Index.
      • Amante D.J.
      • Hogan T.P.
      • Pagoto S.L.
      • English T.M.
      • Lapane K.L.
      Access to care and use of the Internet to search for health information: results from the US National Health Interview Survey.
      In 2016, Ziemba et al
      • Ziemba J.B.
      • Allaf M.E.
      • Haldeman D.
      Consumer preferences and online comparison tools used to select a surgeon.
      completed a survey of approximately 25,000 households in the United States that evaluated factors, including online ratings, underlying the choice of a surgeon. The findings indicated that this population was more likely to search online for a restaurant (50%) than for a physician (21%) or a surgeon (7%). Factors influencing choice of surgeon included insurance issues, a referral from a primary care physician, and the reputation of the surgeon and the hospital. Among those who used online information, the top 3 sites utilized were yelp.com, Healthgrades.com, and the site of a health care system or hospital or group practice.
      The study by Widmer et al
      • Widmer R.J.
      • Maurer M.J.
      • Nayar V.R.
      • et al.
      Online physician reviews do not reflect patient satisfaction survey responses.
      in this issue of Mayo Clinic Proceedings specifically addresses the validity or lack thereof of negative online reviews. They matched 113 physicians with negative online reviews with those in similar fields but without negative reviews and compared the Press Ganey Patient Satisfaction Survey (PG PSS) results (a validated tool measuring multiple domains impacting patient experience) between these 2 groups. Overall, the authors found no correlation between physicians having negative reviews online and the results of the PG PSS, with similar scores exhibited by those with and without negative reviews. Although individuals with and without negative online reviews had similar scores on physician-specific metrics in the PG PSS such as communication skills, those with negative online reviews were more likely to have a lower PG PSS for non–physician-related issues; such issues include, among others, institutional facilities, parking, waiting time to be seen, and patient interaction with the nursing and desk staff. Physicians should, therefore, be aware of the potential negative impact on their online reputation caused by diverse factors that are under institutional control and beyond their specific purview.
      Although negative reviews may not necessarily correlate with poor patient survey results, there is evidence that positive online reviews may reflect quality and augment standardized surveys.
      • Gao G.
      • Greenwood B.N.
      • Agarwal R.
      • McCullough J.S.
      Vocal minority and silent majority: how do online ratings reflect population perceptions of quality?.
      • Ranard B.L.
      • Werner R.M.
      • Antanavicius T.
      • et al.
      Yelp reviews of hospital care can supplement and inform traditional surveys of the patient experience of care.
      Ideally, we help our patients most by providing them access to all of the valid and relevant data they need to make informed and judicious health care decisions. Such decisions include the most appropriate choice of health care professionals, an objective intended by transparently sharing results of validated measures of patient satisfaction, morbidity and mortality statistics, complication rates, and other quality metrics.
      • Werner R.M.
      • Asch D.A.
      The unintended consequences of publicly reporting quality information.
      This important and timely article by Widmer et al conveys a message for major constituents of the health care system. To the patient less than satisfied with the care that was received and who wishes to comment online regarding their dissatisfaction, such online comments would be more helpful if they provide specifics rather generalities. To the patient seeking information online on the choice of health care professionals, a certain measure of circumspection is needed in assessing the basis and cause for negative online reviews and the prudence and benefit of pursuing other sources of information that may refute or corroborate such reviews. For clinicians with negative online reviews, the article by Widmer et al indicates that such negative reviews may reflect organizational and other issues over which individual health care professionals exert no direct control; additionally, there is a certain personal disquietude if not public humiliation for clinicians negatively assessed online. For health care professionals who have other data indicating they deliver high-quality care with good patient satisfaction metrics pertaining to their patient interactions, the findings of Widmer et al do reassure that they personally are still delivering the high standards of care and professionalism that patients expect and entirely deserve. Finally, these findings speak to the leadership of health care organizations as they underscore the totality and integrity of processes, elements, and encounters—and not just the patient-provider interaction—that all need to be effectively and cohesively in place to ensure optimal patient experience and welfare.

      References

        • Amante D.J.
        • Hogan T.P.
        • Pagoto S.L.
        • English T.M.
        • Lapane K.L.
        Access to care and use of the Internet to search for health information: results from the US National Health Interview Survey.
        J Med Internet Res. 2015; 17: e106
        • Ziemba J.B.
        • Allaf M.E.
        • Haldeman D.
        Consumer preferences and online comparison tools used to select a surgeon.
        JAMA Surg. 2017; 152: 410-411
        • Widmer R.J.
        • Maurer M.J.
        • Nayar V.R.
        • et al.
        Online physician reviews do not reflect patient satisfaction survey responses.
        Mayo Clin Proc. 2018; 93: 453-457
        • Gao G.
        • Greenwood B.N.
        • Agarwal R.
        • McCullough J.S.
        Vocal minority and silent majority: how do online ratings reflect population perceptions of quality?.
        MIS Quarterly. 2015; 39: 565-590
        • Ranard B.L.
        • Werner R.M.
        • Antanavicius T.
        • et al.
        Yelp reviews of hospital care can supplement and inform traditional surveys of the patient experience of care.
        Health Aff (Millwood). 2016; 35: 697-705
        • Werner R.M.
        • Asch D.A.
        The unintended consequences of publicly reporting quality information.
        JAMA. 2005; 293: 1239-1244

      Linked Article

      • Online Physician Reviews Do Not Reflect Patient Satisfaction Survey Responses
        Mayo Clinic ProceedingsVol. 93Issue 4
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          Online physician reviews have become increasingly prevalent and are a common means by which patients explore medical options online. Currently, there are no data comparing physicians with negative online reviews and those without negative reviews. We sought to compare industry-vetted patient satisfaction surveys (PSSs), such as Press Ganey (PG) PSSs, between those physicians with negative online reviews and those without negative reviews. Overall, there were 113 unique individuals with negative online reviews from September 1, 2014, to December 31, 2014, with 8 being nonphysicians.
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