The hidden secret about physician reviews

Most of the time, you’d be crazy not to look at reviews before buying something. No item is too small for reviews to matter. I’ve looked at reviews to figure out which electronic unicorn would be best for my daughter, or a $3 stuffed animal. So it’s not surprising that people want reviews to help guide them on decisions about healthcare. And there is some valuable information in reviews, but it’s much more nuanced than you might think.

The business of improving physician reviews is still in its infancy, but there are multiple companies that physicians can hire specifically to improve their reviews. Here are some of their recommendations:

Clearly, these reviews are susceptible to manipulation and need to be interpreted as such.

Even when you’re just buying random stuff, there’s a decent chance that at least some of the reviews are not true. And even when they’re true, there will be ratings that are low for reasons totally unrelated to the product itself - it showed up late, or wasn’t what the person needed.

All these usual caveats that you would normally need to take into consideration about the simplest products also apply to doctors.

Is it a one star review because the doctor was late? Fine, but perhaps there was an emergency that day, or the clinic staff made a scheduling error.

Just like you would normally disregard some of the outlier reviews, the same applies with physician reviews. One or two bad reviews for being late can probably safely be tossed out, but multiple poor ratings for lateness suggest the physician is not managing time well.

The major difference between physician reviews on hospital system websites and practice-specific websites is who decides whether the review stays or not.

Here’s what big hospital systems usually do for their physician review systems:

  • Patient posts a physician review

  • Positive reviews stay

  • Negative reviews are screened by an independent hospital panel. Whether that review is actually posted is entirely dependent on the hospital system. My personal experience is that most legitimate negative reviews are actually kept public, to maintain the integrity of the review system.

Here’s what physicians with their own practices do:

  • Patient posts a physician review

  • Positive reviews stay

  • Negative reviews are screened by the physician, and are therefore much less likely to be posted.

You can see how reviews on physician-owned websites might be higher, and those on hospital system sites might be lower. You can also see how a place like Yelp, which generally does not screen out negative reviews, would likely have lower physician scores.

Another factor to take into consideration is whether the physician requests patients provide reviews. I am not at all suggesting that this is an unethical practice, but it does introduce some bias. Physicians are more likely to request reviews from patients who had a positive experience, and people who are asked to post a review are more likely to do so than people who aren’t. Yelp discourages the practice of asking people to leave reviews, but it still happens.

In summary, physicians with their own practices, and those who request reviews, are more likely to have higher scores. Physicians who work for a hospital system are likely to have more negative reviews, and - in my experience - are less likely to request reviews since they are also more likely to be employed by the hospital and have less invested in the “business” of bringing in new patients via new reviews. Take these factors into account next time you see a physician rating.

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