The 10 Flaws of Physician Rating Sites

Overall, we found that most sites were neither user-friendly nor patient-centered. Patients searching for specific physicians will find that search mechanisms are cumbersome, advertising is prevalent, and information about physicians is incomplete.

Although several recent studies have found that patients place a high value on shared decision making, only one site included questions about patient involvement in decision making. Similar to other forms of public reporting, there was enough variation in structured questions that it was difficult to compare physicians across sites, making side-by-side comparisons difficult.

We identified 33 physician-rating websites, and of those sites, 14 (42% of sites surveyed) allowed physicians to pay a fee to make their profiles more complete or visible. However, only 5 of those 14 sites indicated these “featured” physician profiles were paid advertisements. One site offered a free gift ($200 value) in exchange for reviewing at least eight physicians. Such tactics, while effective as marketing techniques and revenue grabs, truly call into question the objectivity of many of these review sites.

But it's not just conflicts of interest, our team also did some digging and we came up with the ten major shortcomings of physician­ rating websites.

1. Due to incomplete databases, it is shown that many physicians are not even listed on physician­ rating websites. For example, out of a random sample of 298 physicians, between 75% and 98% of the physicians could be found. One site could have a modest library of reviews for physicians, and others can be robust, but if the onus of these sites is to review physicians, shouldn't these sites do a better job of indexing the physicians they're holding up for review?
2. On most physician ­rating websites, only a small number of physicians have been rated so far. As mentioned previously, only 16% of practicing US physicians have received at least one rating on Ratemds in 2010, and only a low number of physicians has more than one rating (eg, only 2% had more than five reviews on Healthgrades in 2008).
3. Patient opinions are unstructured, and ratings systems, as well as the presented information, are different on each physician ­rating website. One study showed that 35 different dimensions of care were rated on physician ­rating websites. Thus, meaningful information cannot be provided, and conducting physician-­patient review meta­ analysis or comparisons is difficult.
4. There is still no (gold) standard for surveys implemented on physician­ rating websites for measuring patient satisfaction. Some authors suggest that long surveys with preset questions are missing a great deal of information and force patients to distort their ideas to fit the questions asked. In addition, star­rating systems may be crude and have dubious validity in the way that different categories are aggregated into an overall score. One study showed that surveys vary significantly with respect to certain quality parameters in order to identify a good doctor’s practice.
5. Although a broad range of information is available on many physician ­rating websites, the data are unlikely to reflect the quality of a physician. Most information is related to structural quality and patient satisfaction. Furthermore, significant measures such as outcomes and patient satisfaction are not risk­ adjusted and, thus, are not likely to reflect the quality of care, but more the case mix of patients served.
6. Abuse is likely on physician­ rating websites, and this leads to potential damage for both doctors (defamation) and patients (misinformation). As individuals can rate anonymously, it is impossible to tell if the rater is a patient or someone posing as a patient. However, it is worth mentioning that physicians also seem to manipulate information on physician ­rating websites.
7. Feedback, delivered anonymously, has limited ability to be related to specific incidents. As a result, it is unlikely that a doctor can learn from posted comments.
8. In case physicians disagree with a comment, they may not be able to respond to negative reviews, as they are bound by privacy laws and a duty to preserve the confidentiality of patient information. In addition, only a few physician ­rating websites allow physicians to respond to negative comments.
9. There is still a great lack of evidence of physician ­rating websites’ effects on physicians’ performance, patient outcomes, or the public’s trust in health care. There is further a lack of knowledge on how physician­ rating websites might be used by patients, why they are used, and the usefulness of the information gathered.
10. In general, the role of patients as reviewers of health care quality is still seen controversially: one argues that patients are not skilled or knowledgeable enough to assess the technical quality of care received. Others state that patients’ experience is an important component of measuring the quality of care.

It can be frustrating for physicians to see unwarranted negative reviews on physician rating sites all across the Internet. These inherent flaws should reflect that it's not always the physician's fault, but it may rather be an unfortunate side effect of digitizing a physician's reputation.

Still, patients look to these physician rating sites to either determine or influence their choice in physicians. It's important to consider these flaws when crafting your online reputation strategy, but we'd also advise against underestimating the influence of these review sites because of their shortcomings. There are ways around these inherent flaws to build your online reputation and use physician rating sites as funnels to attract new patients, which our team will discuss in the coming days. Stay tuned.