While a few lucky people have a longtime family physician, many of us don't know where to turn when we need a doctor who fits our needs and budget. And with so many Americans going without health insurance and paying out of pocket, the desire to find the best care becomes even more pressing. So it's no surprise that sites that review or rate doctors have become very popular tools to help consumers. Unfortunately, a new study casts serious doubt on how valuable these sites actually are.
Physician review websites such as vitals.com, healthgrades.com, and ratemds.com typically provide some key information about the doctor, such as location, hours, languages spoken, board certification and where he or she obtained medical training. The sites also allow consumers to rate the doctor with a numerical score and post comments on their experience.
The sites have obvious appeal. Other studies have shown that 66 percent of Americans who use the Web look for health information online. Half of those will look up their providers, and about 40 percent use physician review websites. Healthgrades.com is the most popular, with seven million visits a month.
"There are a lot of people using these websites," Dr. Chandy Ellimoottil, the lead author of the study, published in the Journal of Urology, told TakePart. "But it's not clear if they are using them for selecting a physician or to look at the perception other people have of their doctor." Also not clear is whether these websites really help consumers find the right doctor or even whether the ratings influence how consumers act at all. Meanwhile, the sites have been criticized by doctors, who say a few disenchanted patients can ruin their reputations with a single, scathing review.
The new study only explored reviews of urologists. Ellimoottil, a resident physician at Loyola University Medical Center, and his colleagues selected 10 physician review websites and looked up 471 urologists on the 10 sites. Most of the urologists in the sample were rated on at least one of the websites. The number of reviews per physician ranged from zero to 64. But the average number of reviews was only 2.4. What's more, fewer than half of the physician reviews included written comments by consumers. "It's a very small number," Ellimoottil says. "There is a lot of volatility in that number." For instance, one highly negative or positive review could wash out one or two other reviews.
The study also found that 86 percent of the doctors had positive ratings, a number that should reassure doctors the sites aren't just used to air grievances. The majority of comments written by consumers were neutral or positive. But there remains no clarity on whether these rating sites do a good job of one of the key things they're meant to do: assess the quality of a doctor. It's hard to know how many consumer reviews would give a reliable impression, Ellimoottil says. However, when the number of comments reaches around 50, the doctor's composite ratings score changes very little, so that may be a tipping point to a more accurate assessment of quality.
But with only 2.4 comment submissions, on average, for doctor sites, consumers are still left guessing. In contrast, Ellimoottil notes, some online restaurant reviews list up to 1,600 consumer comments. "When you get to 1,600 reviews, it's pretty clear what people think," he says.
Consumers may have to rely on more traditional ways to find out about their doctors, he says. State medical board websites are good places to look up information. Health insurance companies may also provide information about the doctors in their plan. And then there is always word of mouth. To find a specialist, consumers can ask their primary care doctor for help, Ellimoottil adds.
It's unlikely physician review websites will fade away. Now, more than ever, consumers need to shop carefully for healthcare services and spend their money wisely, health economists say. Even the federal government supports tools to help people shop for doctors. In 2011, the Centers for Medicare and Medicaid Services established the Physician Compare website to show biographical information about doctors who accept Medicare. That site also allows doctors who report quality measures to have their performance rated publicly; that service will become available starting this month.
Have you used a doctor review site to rate a doctor? Have you used one to find a doctor? Did the reviews you saw on these sites influence the physician you chose?
Shari Roan is an award-winning health writer based in Southern California. She is the author of three books on health and science subjects.