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Consumer Ratings No Panacea for Picking Doctors

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Online consumer ratings were unrelated to actual quality of care by physicians, according to a new Cedars-Sinai study.

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Timothy Daskivich, MD, MSHPM

Online consumer ratings parse everything from tasty burritos to hip beauty salons. While crowdsourced reviews can be helpful when picking a restaurant or hair stylist, are they useful for choosing a physician?

Not entirely, according to a new study by Cedars-Sinai investigators, which found that online physician ratings were unrelated to actual quality of care.

"Studies have shown that over 75 percent of patients are willing to make provider choices based on consumer ratings alone," said the study's lead author, Timothy Daskivich, MD, MSHPM, assistant professor of Urology and director of Health Services Research in the Cedars-Sinai Department of Surgery. "We wanted to raise awareness among patients that online consumer ratings may not be telling the entire story about how 'good' or 'bad' a physician really is."

Daskivich and his team compared consumer reviews of 78 Cedars-Sinai physicians with weighted, specialty-specific performance scores; primary care physician peer-review scores; and administrator peer-review scores. The performance scores included quality metrics, such as adherence to Choosing Wisely measures (electronic health record alerts guiding physicians toward appropriate care for patients), 30-day readmissions, length of stay and adjusted cost of care for patients.

The sample included physicians from eight medical and surgical specialties who used the health system’s electronic health records in their outpatient practices. The consumer ratings came from five popular online platforms: Healthgrades, Vitals, Yelp, RateMDs and UCompareHealthCare. Each website rates physicians using a five-star scale.

"We found that some highly competent doctors had lower consumer ratings," said study senior author Brennan Spiegel, MD, director of Health Services Research and professor of Medicine.

The study, published Sept. 8 in the Journal of the American Medical Informatics Association, found no significant association between average consumer ratings and performance scores. Among physicians in the lowest quartile for performance measures, only 5 to 32 percent had consumer ratings in the lowest percentile on the rating sites.

Consumer ratings were consistent across the websites, which suggested that they jointly measure a latent construct unrelated to performance, the study's authors said.

The team concluded that online consumer ratings should not be used in isolation to select physicians.

"While online ratings are very important in measuring some parts of the patient experience, such as service-related aspects, they are clearly not comprehensive in determining whether the care delivered is high quality," Daskivich said. "It appears that online ratings hold too much sway over how patients make decisions, out of proportion to what they offer in terms of a comprehensive assessment of a physician’s performance."

Additional authors from Cedars-Sinai included Justin Houman, MD, Garth Fuller, Jeanne T. Black, PhD, MBA, and Hyung L. Kim, MD.