Many physicians rail about the unfairness and inaccuracy of online ratings by patients, but in a recent piece in theatlantic.com, Richard Gunderman, MD, vice chair of the Radiology Department at Indiana University, takes a logical and dispassionate look at the problem—and how misleading information can actually harm patients. He begins with the observation that the cohort of raters is usually very small. As with underpowered medical studies, he notes that meager participation in online ratings “lowers the probability that the online rating truly reflects the aggregate views of the physician’s patients…and exaggerates the influence of even a single disgruntled or highly laudatory reviewer.”
While conceding that satisfaction is an important factor in a patient’s encounter with the health care system, and that satisfied patients are “generally more likely to follow a doctor’s recommendations,” he observes that there’s a tendency for patients to overrate convenience factors such as ease of getting an appointment and parking. More important aspects of quality care—a doctor’s knowledge, skill, and judgment—“may be difficult or impossible for most patients to evaluate thoroughly,” he claims.
Finally, he argues that some highly rated doctors are just plain bad, as attested to by last year’s case of a New Jersey cardiologist rated “very good” by patients who defrauded insurers of $20 million and employed unlicensed health care personnel. The worst-case scenario, Gunderman says, occurs when a preoccupation with online ratings impels doctors to act against their own professional judgment to boost their scores.