Rating Doctors Online: Cons Outweigh the Pros

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A growing trend in healthcare has been toward a more patient-centered approach, and patient satisfaction surveys are increasingly used as a measure of quality of care. The government has used survey results to withhold compensation from hospitals, so it makes sense that the issue of reviewing doctors would be a hotly-debated topic.

Here are some of the pros and cons of such a practice (this time in reverse order for a change!)

The first and most important question we should be asking is: Have patient satisfaction surveys actually helped improve the quality of care?

In a paper published in The Practice of Emergency Medicine, the authors state that the literature available demonstrates that there's little consensus about the association between patient experience and the technical quality of care as related to improved health outcomes measures.

They go on further to state that [a] number of studies have failed to demonstrate an association between patient satisfaction and the clinical technical quality of care." The authors conclude by explaining, that based on their review of the available data, they found evidence that has been contradictory suggesting that clinical quality and patient experience may be different domains.


A potentially big problem involves patients demanding useless tests and treatments, and forcing physicians to succumb in order to avoid a bad patient review. Patients usually lack medical expertise, which is why they visit the doctor in the first place. So as a result, what they are rating may not be an accurate measurement of the quality of the medical information they eventually receive.

Another issue involves the possibly of violating the Health Insurance Portability and Accountability Act, commonly known as the HIPAA law, which safeguards a patient s right to privacy. It would blur ethical boundaries for the physician to respond to patients' reviews, so that limits interaction and could possibly breed resentment between the parties.

Let's remember that doctors are not cars, or blenders, or any other inanimate object that yield the same result irrespective of the consumer. It is not uncommon for patients to confuse like-ability with quality of care. Again, how can anyone be certain that the reviews are true reflections of the doctor s skill?

Reviews of physicians provide the patients with a degree of leverage. This can also make it potentially intimidating for doctors, and for them, in turn, to develop a degree of mistrust. Moreover, studies have shown that consumers are much more likely to write a negative review than a positive one. Patients may avoid a doctor who is very skilled in his/her duties, simply based on negative ratings or reviews.


On the other side of the ledger, a positive aspect of physician reviews is the notion of the wisdom of the crowds, in that any single review may not carry as much weight as the overall assessment. Any negative review could be an outlier if the general consensus is positive.

Additionally, physician reviews could provides doctors the opportunity to see where and what they can improve. They may not have been aware of patients' dissatisfaction. Online reviews can take away the fear of the patient to criticize their doctor because they are in a safe space.

To genuinely measure actual quality of care through surveys, I feel is tough, if not impossible to accomplish -- there are simply too many confounders and data prove that. Online reviews are problematic, as they are driven by emotion, especially when regarding other humans.

It's important to keep in mind that reviews of hospitals have not led to improved patient outcomes. Similarly, it's hard to see how online reviews of physicians can have a different result for patients. In my opinion, doctors are practicing defensively already, and to add the threat of bad online reviews can only further damage relationships, helping to erode an essential foundation of trust. That does not sound like improved quality of care.