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Patient Care

Online Reviews: A Thumbs-Up for Healthcare?

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Online physician reviews and find-a-doctor apps grow in popularity, but no one solution has emerged

You shouldn’t be surprised that online reviews have finally spread to healthcare; after all, consumers are having their opinion heard in nearly every other types of service, including restaurants, barbershops and gyms.

It has taken longer for healthcare to be impacted by consumer reviews, but it’s catching up, according to a new report by PricewaterhouseCoopers.

As people spend more money out of pocket on healthcare in this changeable insurance environment, consumer feedback matters more when making health choices.

According to the PwC survey, nearly half of respondents reported reading healthcare reviews online, though only about a quarter had written a review.

Still, more than two-thirds of the people who had read reviews used the information to select a doctor, hospital, health plan, pharmacy or drug. That “could be an indicator that better awareness and understanding of reviews could affect the future success of a doctor, hospital, insurer, or retail pharmacy,” PwC said in the report.

People use forums like Facebook and WebMD, consumer rating sites like Yelp and Healthgrades, and nonprofits like Consumer Reports, according to the report, but there is still no industry standard go-to resource for ratings.

Patients care most about a doctor’s bedside manner, the survey shows, and it’s that emphasis on personal relationships – a relic of pre-internet community doctors – that may have slowed the adoption of ratings systems for healthcare in particular.

But in recent years medical rating apps have proliferated. ZocDoc lists available appointments with local providers in 24 major U.S. cities alongside user reviews and filters by specialty and insurance plan. Similar apps include BetterDoctor, PhysicianFinder and iTriage.

At the same time, patient satisfaction has become an important factor in Medicare payment policies. In October 2012, as part of the Affordable Care Act, Medicare began rewarding hospitals with high patient satisfaction through the Hospital Value-Based Purchasing Program.

Starting this year, $850 million in Medicare bonuses are up for grabs for hospitals, and will be awarded based on clinical measures of effectiveness and on patient satisfaction scores, weighted at 70 percent and 30 percent importance, respectively. Washington D.C. and New York state area hospitals were recently at the bottom of the rankings, with only 59 percent of patients giving them top a top rating, according to Kaiser Health News.

But online reviews of doctors and hospitals aren’t rigorous enough yet, according to the PwC report.

“We advise people to choose doctors not just based on what patients say about the doctors,” said Robert Krughoff, founder of Consumers’ Checkbook, which combines randomized consumer surveys with independent data to review doctors as well as cars, plumbers, electricians and repairmen.

“Find a doctor who’s board certified, who is has admitting privileges at a high-quality hospital, teaching privileges at a hospital,” Krughoff told HealthBiz Decoded. “You should find a doctor who is moving forward and using electronic medical records, who has a system and uses it constructively, and you’ll be able to see your personal health record that the system generates – with reminders for you to get tests and treatments.”

Checkbook uses a rigorous system of surveys developed by a team of sophisticated researchers, includes rating from patients and from other doctors, and doesn’t take advertising dollars, he said, unlike most online review systems.

Krughoff cautioned that some sites don’t use standardized questions and are vulnerable to manipulation. And with the small sample sizes, too much is dependent on luck. You might skim the first five reviews and see that they are positive, he said, but that doesn’t reflect the whole body of evidence.

Dr. Robert Rosenkranz, one of the most reviewed dentists for the New York area on Yelp, said he appreciates the positive feedback online but would caution others from using it to choose practitioners.

“If I was a consumer I would always go to the Internet, because the best way to find anything is of course referral based,” Rosenkranz told HealthBiz Decoded.

“But you don’t know if it’s true or not,” he said.

There are hundreds of sites where people can look for providers, he said, and Facebook can be a good resource because at least there you are likely to know the people giving recommendations.

The Affordable Care Act required the government to set up a Physician Compare website, but Krughoff said it needs more time and attention before it can really be useful for people.

“It could be the go-to source for information, there was vision in putting it into the legislation, but that vision has not yet been realized,” he said.

Until then, other informal sources like Yelp and Facebook, and nonprofits like Consumers’ Checkbook, will continue to chip away at old-fashioned word-of-mouth referrals.

“The truest way of getting business is to do what you love,” Rosenkranz said.