The power of patient reviews

Recently the media turned its attention to critiquing the value of online physician reviews and ratings as a means of choosing a doctor.

Niam Yaraghi, a fellow at the Brookings Institution, slammed patient review sites such as Yelp in an opinion piece in US News & World Report. He argues that patients are "neither qualified nor capable of evaluating the quality of the medical services that they receive."

I recognize the media pendulum swings on everything from politics to science, and reviews are now in the crosshairs of the press. But as the Founder and Executive Chairman of a company that provides cost, quality and accessibility information to help consumers make informed choices around physician selection, I felt the need to respond emphatically to the shifting tide.

Patient reviews matter. Let me tackle some of the critiques I've seen of late...

"Online reviews are not trusted sources of information": This just isn't true... As Adams Dudley from UCSF's Center of Health Care Value, points out in the Healthcare Blog, there's a strong correlation (0.49) between Yelp ratings and ratings on the Consumer Assessment of Healthcare Providers and Systems (CAHPS) hospital measure (the state-of-the-art method of measuring patient experience).

The truth is there's a nuanced degree to how much reviews can be credible. Trust increases with volume. Web consumers today are increasingly savvy at decoding reviews for purchase decisions of all kinds. While they rightfully should be skeptical of a singular review, 6 or 7 paint a more detailed, accurate picture. Outliers should be expected, but consumers know to scan for trends: Are the majority of reviews favorable or negative? Are there several complaints of long waits? Rude staff? More than 100,000 reviews are being left on Vitals every month by patients. Those contributors bolster the confidence we place in doctor reviews.

Recommendations from friends and family will always be a primary source, but reviews from groups of patients, on sites like Vitals, can come pretty close.

"Reviews are not an effective quality measure": Research published in the Journal of the American Medical Society found that 25 percent of U.S. adults consult online doctor-rating sites, and more than one-third of them went to a doctor – or avoided one – based on the ratings. But reviews, like any other data point, should never be taken in isolation. Reviews provide a meaningful yardstick. But to take the full measure of a doctor, more information is needed. Vitals compiles proprietary and public information from over 170,000 sources on doctors. From cost to quality and accessibility, we're committed to providing relevant information that informs people about their care choices. Reviews are one part of that equation.

On quality, I should also note that we recognize how important this factor is for patients. While we often hear the healthcare conversation center around cost, quality may matter even more to patients than cost. In fact, a 2014 survey we conducted found that almost 40 percent of respondents cited quality of care from doctors and hospitals as their biggest healthcare concern, while only 24 percent said cost of health insurance.

"Reviews do not focus on outcomes": Clinical outcome measures are a far better source of this information. Patient reviews often tell us what patients think about their outcomes – post-surgical pain, do they feel cured, etc.

Of course, outcome measures, in general, have limited applicability. If you bring your child to a pediatrician for an ear infection, you'll likely not return when it clears. It's hard to track outcomes for care that is routine. Relationships with our primary care doctors are built on those experiences: Was I listed to? Did I get seen quickly? How did the staff handle my billing concerns?

People get sick. And they expect to be treated with dignity and humanity by their care providers. Just because reviews don't focus on surgical outcomes, doesn't make them any less useful. In fact, studies have shown that the softer attributes most often cited in reviews matter greatly. The better the patient experience, the better the clinical outcome. Recent legislation and consumer demand will help data on outcomes, recovery times, infection rates, and re-admittance become available over the next decade. We absolutely look forward to that future.

Transparency, shopping, consumerism - whatever you call it – it's clearly where healthcare is headed and needs to go. It's not unfair to have different expectations of healthcare reviews than travel, dining or even small business reviews. But almost everyone would agree that when it comes to important health decisions, more information is better than less. We're focused not only on adding more information, but useful information. And we will continue to make it available to consumers so they can make their own highly personalized healthcare choices.

Mitch Rothschild is the Executive Chairman and co-founder of Vitals, a healthcare transparency company that connects patients to quality, cost and accessibility data on health care providers. Vitals also offers a cost and quality transparency platform to health plans to help their members search for and evaluate providers and costs (VitalsChoice) and an incentive and engagement program to guide members to the highest-quality, lowest-cost option and achieve measurable savings for members and plans (SmartShopper). Rothschild launched Vitals in 2008 after personally experiencing the complexity of finding a qualified physician for his knee surgery. For the company's first seven years, he served as CEO.

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