Reviews of goods and services are commonplace online, with nary a thing we consume not available for review by consumers. This is certainly the case with healthcare, where doctors are routinely reviewed by patients. Do these reviews reflect the clinical outcomes, however? That was the question posed by new research from The University of Texas at Dallas.
“Many patients use online reviews of physicians for deciding which physicians to see and which to avoid,” the researchers explain. “At the same time, though, some physicians have become quite wary of these websites, and they have even filed defamation lawsuits over negative patient reviews. In short, while patients seem to trust the reviews, the physicians don’t.”
The researchers were particularly interested in how chronic diseases are covered by online reviews of physicians, as previous research hasn’t explored this particular area in depth, despite approximately 90% of American healthcare spending going in this domain.
“Any chronic disease, by definition, is treatable but not curable,” the researchers say. “Think of a diabetic patient who needs continuous care and whose disease will never fully subside. Contrast this with an acute-care service, such as surgery to fix a broken leg. If the patient can walk soon after the surgery, the patient would know the surgery went well and could write an online review of the surgeon. However, when there is no visible recovery cue, as with chronic diseases, how can patients possibly know how well doctors treated them?”
Complex picture
The situation is further complicated by the fact that anyone with a chronic condition may see several doctors over the years, while a wide range of socio-economic factors can influence the outcome of any treatment. It all makes providing an accurate review extremely difficult.
“Naturally, one ought to ask, ‘Are chronic-disease patients capable of writing reviews that can inform prospective patients about the true care quality provided by a physician?'” Lahiri said. “In other words, should we trust the reviews that we see on websites such as Vitals, Healthgrades and Yelp?”
The researchers explored a decade worth of data from COPD patients in the North Texas area. They tracked the clinical journey of each patient via their admission-discharge data, while also looking at the online reviews of physicians.
Lack of alignment
The analysis revealed that the online reviews for clinicians didn’t really match up with the quality of care they provided, at least in terms of risk of readmission and other commonly used clinical outcomes. This was true for both the star ratings provided to each doctor and the textual reviews they received.
“The result was indeed a surprise,” the researchers say. “Since prior research on online reviews is mostly based on search goods and experience goods, it typically finds that online reviews are useful to prospective consumers. A key takeaway is that the efficacy of online reviews of search and experience goods does not extend to credence goods, such as chronic-disease care.”
The authors believe that their findings should prompt us to apply caution when looking at the reviews doctors receive, as they are quite probably not at all representative of the quality of care you’re likely to receive. They also suggest that hospital administrators themselves should be wary of using these reviews in the assessment, and remuneration, of their doctors.
“Our message to hospitals would be that online reviews of physicians do not necessarily provide the best proxy for quality, especially in the case of physicians treating chronic-disease patients,” they conclude. “Also, patient surveys administered by hospitals may have similar issues, so hospitals should be very careful when evaluating physicians treating chronic-disease patients.”
