"Consumer-driven healthcare and an increasing emphasis on quality metrics have encouraged patient engagement in the rating of healthcare,” said Benedict Nwachukwu, MD, MBA, who presented the findings at the 2017 Annual Meeting of the American Academy of Orthopaedic Surgeons.
“As such, online physician rating websites have become mainstream and may play a potential role in future healthcare policy.”
Tool for Gauging Patient Satisfaction?
Physician rating sites have become a popular outlet for patients to express their satisfaction or dissatisfaction. They've also been shown to influence physician selection.
For their study, HSS researchers evaluated online ratings for orthopedic sports medicine surgeons, determined predictors of positive ratings, and attempted to correlate scores posted on the websites Heathgrades.com, Vitals.com, and Rademds.com.
"Although it is debatable whether these websites in their current form truly capture patient satisfaction and objectively evaluate the delivery of care, they represent a potential tool for both payers and healthcare systems to gauge how surgeons are assessed by their patients," said Anil Ranawat, MD, senior investigator and a sports medicine surgeon at HSS.
"Historically, 3 key qualities – affability, availability, and ability, known as the ‘3 A's’ – have been suggested to promote a successful surgical career and favorable interactions with patients."
Factors Influencing Ratings
To identify surgeons for the study, researchers accessed the online member directory of the American Orthopaedic Society for Sports Medicine. Their query in May 2015 yielded 2,813 entries, and they selected every 10th surgeon profile on a continuous basis to yield 275 sports medicine surgeons for inclusion in their study.
The researchers compiled data on years in practice, location, academic affiliation, and ratings for each surgeon on the 3 websites. Patients' written comments were categorized as relating to surgeon competence, affability, and the process of care delivery.
They discovered a low degree of correlation in ratings for individual surgeons on the different websites, an important finding that had not been previously demonstrated, according to Dr. Nwachukwu.
With respect to factors that appeared to influence ratings, being female was a significant predictor of higher ratings on Healthgrades. Surgeons with an academic affiliation were also more likely to receive higher overall ratings.
A surgeon’s online and social media presence, including Facebook, Twitter, and personalized website, did not influence the strength of ratings on Healthgrades, Vitals, or Ratemds.
Surprisingly, across all 3 websites, an increased number of years in practice generally led to lower ratings.
Confirming the 3 A's
Out of 2,341 written comments that were analyzed, perceived surgeon competence and communication skills influenced the scores for the highest and lowest-rated surgeons, but did not affect scores for those with average ratings.
"Surgeons with the highest and lowest ratings were significantly more likely to receive comments about their competence or affability," said Dr. Nwachukwu. "As such, it appears that even in the modern era, and with the adoption of online rating mechanisms, the traditional 3 A's of availability, affability, and ability still hold sway."
"Online rating websites are for-profit business enterprises, which at this point demonstrate significant growth potential," said Dr. Ranawat. "However, the low degree of correlation between these websites is concerning. It also questions the collective utility of these sites and potentially demonstrates the individually capricious nature of online physician reviews."
The variation in ratings among the sites may be explained by an insufficiency of reviews necessary to appropriately grade a surgeon, according to the researchers, who noted that the number of reviewers needed to improve reliability is unclear and may warrant further investigation.
"An understanding of the factors that influence online physician ratings may have important implications for sports medicine surgeons, and for physicians in other specialties as well," Dr. Nwachukwu concluded.
"Perhaps more attention should be paid to improving the validity of online ratings for assessing quality and the outcome of care provided."
