Help! I’m On
James A Colbert MDNewton-Wellesley Hospital
Brigham & Women’s Hospital
Bradley H Crotty MD MPH FACPBeth Israel Deaconess Medical Center
How Online Ratings are affecting Physicians
@jcolbertMD
@bradcrotty
2Department of
Medicine
Agenda• Introduction & Framing Questions
• Landscape
• Framework
• Practical Approach
• Discussion
44%+
of web users search the web aboutdoctors or other health professionals
Fox S. Health Topics. A Report of Pew Internet & American Life Project. 2/11/2011Fox S, Jones S. The Social Life of Health Information. Pew Internet & American Life Project. 6/11/2009.
6Department of
Medicine
Questions• Am I being rated? How do patients rate me?
• Are online ratings correlated with actual quality?
• Do online ratings matter?
• Do online ratings change clinician behavior?
• How do I engage with this new trend?º (How) Do I address negative reviews?º Can reviews help my practice?
8Department of
Medicine
The Landscape of Physician Rating Sites
Physician Evaluation Websites
Health Websites with Physician Evaluation Functionality
General Rating Websites
Healthgrades.com Doctor.com Angies List
Findadoc.com Everydayhealth.com Insiderpages.com
Ratemds.com Healthtap.com Yelp
Zocdoc.com Wellness.com Yahoo
Drscore.com
Ucomparehealthcare.comVitals.com
Docspot.com
14Department of
Medicine
Physician Online Ratings WebsitesPros:
• Provide healthcare consumers with information to help them make better decisions about where to receive care
• A way to share personal experiences regarding quality of patient experience with others
Cons:
• Ratings and comments can be left anonymously
• Patients may value customer service more than healthcare quality
• Small number of ratings could harm a physician’s reputation
• Reviewer anonymity – can be subject to manipulation by patients or providers
15Department of
Medicine
Gao JMIR 2012• As of 2010 approx. 1 in 10 US physicians had an
online review
• OB/GYN most likely to be rated
• Mean score of 3.93 on 1-5 scale
16Department of
Medicine
Gao 2012 JMIR
Breakdown of physicians rated online
Primary Care41%
Medical Specialties
16%
Sugeons20%
OB/GYN12%
Other Specialties
12%
Primary
Care
40%
Medical Specialties
10%
Sugeons16%
OB/GYN6%
Other Special-ties28%
National Physician Population
18Department of
Medicine
Online Sample of 250 MA Physicians
Physicia
ns liste
d on websit
e
Physicia
ns with
a rating or r
eview
1–4 Reviews
5–9 Reviews
10+ Reviews
060
120180
Healthgrades RateMD Wellness
19Department of
Medicine
Online reviews of 500 urologists
• 80% had an online review
• 86% of reviews were positive
• 45% had written patient comments onlineº 25% negativeº 22% neutralº 53% positive
Ellimoottil, Journal of Urology 2013
21Department of
Medicine
Quality of Ratings by Physician Characteristics
Primary
care
Medica
l specia
lties
Surg
eons
Obstetri
cs/gyn
ecology
Other specia
lties
4.04
3.953.9
4.04
3.63
Chart Title
Before 1980
1980–1989
1990–1999
2000–2009
3.85
3.953.99
4.22
Specialty* Medical School Graduation Year*
Gao 2012 JMIR* p < 0.05
22Department of
Medicine
Quality of Ratings by Physician Characteristics
Board Certification Status*
Medical School Ranking*
Board ce
rtified
Not board
certi
fied
3.96
3.86
Ranked top 50
Ranked below top 50
4.08
3.91
No malpracti
ce cla
ims
At least
one malpracti
ce cla
im
3.97
3.82
Malpractice Claims#
Gao 2012 JMIR
* p < 0.05 # p > 0.05
23Department of
Medicine
National Patient Survey Data
Hanauer, JAMA 2014
Aware of Rating Websites
Sought Ratings In Last Year
Found Reviews Useful
*Only 5% had written online ratings
24Department of
Medicine
National Patient Survey Data• 59% thought ratings to be important when selecting a
physician
• 35% reported selecting a physician based on good ratings and 37% avoided a physician based on bad ratings
• 34% had concerns about their identify being disclosed
• 26% were concerned about their physician taking action against them
Hanauer, JAMA 2014
25Department of
Medicine
To Summarize…• Patients are frequently rating their clinicians,
though to date any one clinician generally has a low number of ratings.
• Patients are variably (but increasingly) using these ratings to drive decisions
• Ratings tend to be positive
• What are the implications for me?
• How do I think about this?
28Department of
Medicine
Probiotic• Indications:
º Proactive identity managementº Building practice
• Dosing:º Spectrum of engagement
• Alternate Dosing:º Outsource reputation management
29Department of
Medicine
Do Nothing
EncourageReviews
SelfReviews
Non-DisclosureAgreements
ProactiveIdentity
Management
EngageReviews
30Department of
Medicine
Antibiotic• Indications
º Misinformationº Slander
• Mechanism of Actionº Request of Siteº Legal Action
31Department of
Medicine
Implications• Patient Volume and Referrals
• Patient-Doctor Relationship
• Ethical Considerations
• Patient Privacy
• Time & Resources
33Department of
Medicine
• Systematic web searching using search engines
• List professional information, rating sites, and what personal information is available
• Note erroneous information
• Inventory your personal information
º Social Networking Sites
º Online Contactsº Picture Sharing
Sites• Adjust privacy
settings to match your comfort
The Digital Audit
34Department of
Medicine
Practical Steps• Separate personal from professional identities
• Perform digital audits or create automated searches
• Plan goals
• Decide how best to engageº At a minimum, have an online bio or contact information for your
practice available for patients
35Department of
Medicine
Make An Individualized Plan…• What are your needs?
• What are your goals?
• How much time do you want to invest?