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TechTank

When choosing a doctor, patients prefer online reviews to government ratings

In recent years, online reviews have become more popular than ever, and reviews for physicians and medical providers are no exception. Ratings of healthcare providers are growing in importance and popularity both in the US and around the world. Unlike other businesses though, medical providers receive ratings from both federal and commercial agencies.  For example, the Centers for Medicare and Medicaid Services (CMS) rates medical providers. Through initiatives such as Hospital Compare, CMS reports quality data on both clinical and non-clinical aspects of medical services. Surgical complications, infections, readmission, and death rates are examples of metrics that measure the clinical aspects of medical care.

Surveys of patients’ experiences, such as the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS), capture metrics that measure non-clinical aspects of care. In parallel with CMS, commercial websites such as Vitals, RateMDs, and ProPublica also collect and report quality metrics on both clinical and non-clinical aspects of care. The ratings on different aspects of care provided by different agencies are often uncorrelated. A hospital that has 5 star ratings on Yelp may have a 1 star rating from CMS. Given these alternative ratings, how do consumers choose a physician?

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Screenshot of the choice-based experiment.

To answer this question, my colleagues Weiguang Wang, Guodong Gao, Ritu Agarwal and I conducted an experiment which asked 1000 Americans to choose a doctor from a pair of hypothetical physician profiles with various ratings from governmental and commercial agencies on different aspects of medical care. (You can try the experiment for yourself here). Analysis of these data revealed the relative importance of ratings on how individuals choose a doctor. We found that for patients to choose a doctor, non-clinical ratings from commercial websites are as important as clinical ratings provided by the government. The importance of non-clinical ratings from commercial websites become ever more salient among female patients.

While the government has expended substantial resources on clinical quality ratings, our study indicate a need to acknowledge the importance of non-clinical measures also. This is consistent with the recent CMS efforts and policy recommendations to tie reimbursements to patient satisfaction. Our result on gender differences in the relative salience of non-clinical ratings further revealed the importance of improving the patient experience for providers who focus on women’s health services.

Patients are accustomed to relying on commercial websites for non-clinical ratings. CMS should consider strategies to increase patients’ awareness about the availability of non-clinical ratings, including partnerships with commercial websites.

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