Give it 5 stars: How doctor ratings affect your health care
Give it 5 stars: How doctor ratings affect your health care. Consider a fantastic experience at a restaurant with delicious food, timely customer service, and amazing ambiance. A diner may feel compelled to give that business a five-star rating on Yelp. It exceeded expectations and the restaurant can benefit from the power of a positive online review.
Now consider a visit with a physician. What would make it a five-star experience? And how would excellent service be defined in the medical setting?
As a physician, my goal is always to deliver effective and empathic health care to all of my patients. My goal is not to receive a high rating. Due to bias, subjectivity and other motivations, the random online patient ratings system is a hinderance, not a reliable guide, to good health care.
For many Americans, the end of the calendar year means they have already met health insurance deductibles and out-of-pocket maximums. This can make medical services less expensive and lead patients to search online for new physicians. However, in deciding on a doctor, patients need to be cautious not to confuse customer satisfaction with evidence-based, patient-centered care.
When making decisions about their health, patients are acting increasingly like typical consumers, who value online ratings. According to a 2018 study from NRC Health, “92.4% of consumers use online reviews to guide most of their ordinary purchasing decisions.” The survey revealed that “59.9% of patients say they’ve selected a doctor based on positive reviews, and nearly the same percentage (60.8%) of patients say they’ve avoided doctors based on negative reviews.”
These trends have huge implications for the quality of health care in the U.S., since patient ratings depend on often-inaccurate — and potentially biased — patient perceptions, rather than on more objective measures of good medicine.
Research shows that patient ratings tend to be biased against female and minority physicians. A 2018 study in the Women’s Health Issues journal showed that “women gynecologists are 47% less likely to receive top patient satisfaction scores compared with their male counterparts owing to their gender alone.”
Another 2019 study in Health Equity found “significant difference in patient satisfaction scores between underrepresented and white physicians.”
Additionally a 2018 paper in the Journal of General Internal Medicine shows the different expectations that patients have for female and male physicians. “Female patients tend to seek more empathic listening and longer visits, especially with female physicians.” As a result, patient satisfaction with female physicians is “subjected to gendered stereotypes and expectations with hidden rules for appropriate behavior.”
Even if this implicit bias is overlooked in physicians, online reviews for products and services are hardly reliable.
Recently the skin care brand Sunday Riley settled with the Federal Trade Commission after the company was accused of posting fake reviews of their products on Sephora’s website for two years. Thirty percent of Amazon product reviews also were found to be falsified by Fakespot, which analyzes online ratings for accuracy.
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