A recent post on the U.S. News & World Report blog “Policy Dose” skewered the rising popularity of online reviews in the healthcare sector. The author argued they’re worthless:
The argument is misguided. I know. I used to feel the way he did. Then, we analyzed the data. We’re now reformed skeptics. First, some background.
The “healthcare is not a restaurant” analogy
Applying the author’s argument to restaurants, consumers are equally unqualified to judge the culinary prowess of the chef at their favorite upscale bistro. How many of us actually pull out a meat thermometer before eating? We poke, prod, color check and eat. Nonetheless, we’re the experts of our own experiences with the chef, mechanic, exterminator… or doctor.
“Anybody can say if the steak is too chewy, the atmosphere is not pleasant, or the waitress is rude.” – Niam Yaraghi
Similarly, as patients, we can tell if our wait time is too long, the front office/check-out staff is poorly trained, or the doctor, PA or nurse has terrible bedside manner. We can also identify whether or not our condition improved.
When a patron rates a restaurant, he is not rating whether the meal was cooked to the technical specifications that the culinary discipline and the FDA call for.
The person enjoying the meal cares about the satisfaction the meal provides, not the technical know-how that went into making the meal. The ambiance of the restaurant, the efficiency, friendliness and professionalism of the servers, and the quality of the ingredients – these are the factors tipping the balance for “elite” Yelpers, positive or negative. More often than not, bad restaurant experiences feature a rude waiter, delayed service, distracting decor, or a bone in your Chilean sea bass.
In online reviews, consumers share their experiences. Arguing that healthcare consumers are “neither qualified nor capable of evaluating the quality of the medical services they receive” misses the point, and unfairly tarnishes a worldwide trend that shows no signs of letting up. The statement also mischaracterizes the role of online reviews. Is the average consumer any more likely to be educated about the culinary techniques used to prepare a souffle than a medical technique used in suturing? No.
Health care consumers are not rating the doctor, the hospital or the family practice they visit – they are rating the patient experiences that doctors, hospitals and family practices provide.
The bottom line is… they’re rating.
Crowdsourcing to the “best”
Consumers want to share their experiences, tapping into what their peers think about the seemingly everyday tasks like car repairs, medical appointments or filing taxes. Luckily, the all-encompassing social media ecosystem has amplified the simple “Hey, how is your insurance guy?” neighborly exchange into a never-ending stream of information about the “best” neighborhood guy, in every neighborhood.
Give Yaraghi credit where credit is due, crowdsourced information has repeatedly been proven reliable – “While people have different tastes and thus evaluate similar qualities differently, the overall ratings provided by a large enough sample of patrons give a fairly good sense of what is going on in that
Back to our original premise.
Can reviews be trusted?
“Patients are neither qualified nor capable of evaluating the quality of the medical services they receive.” – Niam Yaraghi
We were skeptical, too. So, we did the research. Here’s what we learned. A doctor’s online reputation correlates with proxies for quality of care – namely safety and clinical outcomes. In 2012, our study in The Journal of Medical Internet Research analyzed the online reputations of “high volume surgeons” and “low volume surgeons” across three surgical procedures (lumbar surgery, knee replacement and bariatric surgery). High volume surgeons had better safety records and clinical outcomes than low volume surgeons. The results showed that online reviews can be used to differentiate between the two surgeon groups. The study was the first to conclude that online reviews could be used to predict the quality of care of doctors – precisely the point the blog’s author dismissed.
The result of a single study is not the end of the story – more research is needed. Nonetheless, the findings reflect the emerging reality that healthcare consumers are, more than ever, utilizing the Internet to make and affirm their medical choices. This is a good thing.
Increasingly, consumers are finding and using their voices in online settings. Let us know what you think – are patients qualified to comment on their own experiences with their medical providers?