Wednesday, October 8, 2014

1:56 PM

Huaxia Rui and Susan Lu

Huaxia Rui and Susan Lu say when it
comes to some online physician reviews,
you can believe what you read.
A new paper by assistant professors Huaxia Rui and Susan Lu suggests that despite media criticism to the contrary, online physician reviews can be trusted, at least those of cardiac surgeons. The paper, “Can We Trust Online Physician Ratings? Evidence from Cardiac Surgeons in Florida,” is the first to look systematically at the correlation between online ratings and medical performance.

Pundits have decried online physician ratings as simplistic popularity contests in which punctual doctors with friendly staffs are rated more highly than the most skilled.
Using patients’ ratings at RateMDs.com and data from Florida Hospital Discharge, the authors studied whether online ratings in fact reflect the medical skills of cardiac surgeons.

“We started with one initial question,” Rui says. “When we try to find a surgeon, does information online about their rating tell us anything?”

Rui and Lu were surprised to learn that patients of surgeons with five-star ratings have a much higher mortality rate. The answer lies in patient selection: Those who are very sick are more likely to select doctors with high ratings than lower-rated surgeons.

“Those physicians are very highly skilled and more likely to treat those high-risk patients. So if you’re looking only at high mortality rate it’s not fair,” Rui says. “When the severity of illness is taken into account, what we find is that doctors with five-star ratings have smaller mortality rates if you consider the patients treated by them are more risky.”

Online physician ratings are subjective measures of physician quality and may complement objective
measures such as mortality rate.

“People do take into account their own risk level when they rate physicians. If they’re OK but not real sick, they won’t try to seek the highly rated doctor for treatment. And when they recover, they won’t give such a high credit to the doctor either. On the other hand, if they’re really sick, they tend to seek highly rated doctors and, once recovered, they really give credit to the doctor,” Rui says.

To test what traits patients are looking for, Rui and Lu measured patient responses to the four dimensions commonly asked in online ratings: helpfulness of the doctor, his or her level of knowledge, staff courteousness, and doctor punctuality. The study found that patients selected doctors based on their level of knowledge and their helpfulness—not staff manners or punctuality.

“This is evidence that patients are not naïve,” Rui says. “They do know what matters is the knowledge or skills of a doctor.”

There are very few reviews of doctors, and critics argue that their scarcity makes them an unreliable source of information. The authors plan to study why there are so few physician reviews.

By Sally Parker

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