Short Takes On News & Events

Hospitals Get Into Doctor Rating Business

By Phil Galewitz

April 17th, 2014, 5:00 AM

After some doctors at University of Utah Health Care noticed scathing online reviews about themselves in 2012, the hospital system decided the best way to respond was by posting its patients’ ratings of physicians on the hospital’s own website.

The hospital was already randomly surveying patients about their experiences with physicians.

Now, when potential patients use online search engines to look for a University of Utah Health Care doctor, the hospital’s reviews pop up first. “We knew our patient satisfaction scores were really strong and we had a good story to share with our patients,” said Brian Gresh, senior director for interactive marketing & web at University of Utah Health Care.

Even though every University of Utah Health Care doctor scored a four- or five-star rating out of a maximum of five stars, Gresh notes that not all the published comments left by patients on the website are glowing.

While that was the first hospital system to start posting individual doctors ratings, others are contemplating the move, said Dr. James Merlino, chief experience officer, at the Cleveland Clinic. “This is clearly a trend that is coming,” he said, adding that his own institution is looking into it.

Many hospitals have surveyed patients about doctors for decades, but the data was usually only used internally. In the past few years, some hospitals including the Cleveland Clinic, have started showing doctors how they compared to each other on the ratings. “Doctors are highly competitive and no one wants to be on the bottom of the list,” Merlino said.

Online ratings of physicians haven’t caught on as much as ratings of books and movies, but medical information sites, such as Healthgrades and Vitals, and broader consumer sites including Yelp and Consumer Reports offer physician reviews. Some score doctors based on patient surveys, and some allow patients to post comments. A research letter in the Journal of the American Medical Association found that one in four patients consulted them when picking a primary care doctor in 2012.

Integris Health, Oklahoma’s largest hospital system, plans to start posting consumer satisfaction scores for 70 of its physicians by the end of April.

“Our No. 1 reason for doing this is we wanted to be transparent with our patients,” said Gary Brown, Integris’ manager of service excellence. “We want our patients to have as much knowledge as they can about our physicians.”

Of course, patient satisfaction data should just be one tool patients consider when choosing a doctor, the hospitals say.

To make sure the doctor ratings are more than just a “marketing gimmick,” Merlino said hospitals should also publish the surveys of patients which they are required to provide to Medicare. Medicare posts that information on its Hospital Compare website. However, that data do not include information on individual physicians.

Paul Clark, a Nashville-based health care consultant, said patient ratings may give some insight into whether the physician was considerate and communicated well, but they don’t evaluate a physician’s clinical competence.

Clark expects more health systems that primarily use employed doctors to follow the trend, but not those that that depend on independent physicians. “Most hospitals fear this would harm their relationship with the physician,” he said.

14 Responses to “Hospitals Get Into Doctor Rating Business”

  1. evan says:

    It’s about time! Doctors aren’t as perfect as they claim they are. They need to be rated and the bad apples need to be tossed. We need to encourage more participating of nurse practitioners and physician’s assistants in our healthcare system. We don’t need doctors removing warts and giving flu shots.

  2. A doctor says:

    Attaboy, Evan. Screw those doctors. Who do they think they are? Make them bow to their administrative masters!!! More NPs and PAs!!! Go see one next time you have meningitis…. then die.

  3. Holly, RN, FNP says:

    Consumer satisfaction scores can punish providers who recommend treatment that the patient may not wish to hear such as losing weight, getting off drugs and alcohol, etc. Healthcare is a professional service, not a consumer service where the “customer is always right”. Oxycodone is not necessary for a sore throat! Give physicians technical assistance and NPs and PAs to handle the more routine illnesses with consultation with the MDs, and free up the MDs to focus on diagnosis, treatment, and consultation with experts so that communication is clear, care less fragmented, with less unnecessary/duplicative testing.

  4. Gill says:

    As a healthcare consultant, this trend disturbs me. I compare it to a few hospital clients I have had who didn’t like their low quality ratings, so they made up their own system. Wishful thinking doesn’t solve anything. However, I’m sure patients are savvy enough to realize a health system’s ratings of its own doctors on its own website will be significantly biased. That’s why third party ratings sites exist–in any industry.

  5. Anthony says:

    There is an assumption here that “scathing online reviews” have an impact on a hospital’s brand and on the decision making process of prospective patients. Where is the research that shows that? Are internal staff overly sensitive to some flaming remarks due to the free wheeling style of content? In this case, at least, it appears so.

  6. A patient says:

    The mention of yelp concerns me. My experience as a yelp reviewer has lead me to the opinion that yelp is in the extortion business. I got great service from a business, gave them a long positive review. That review lasted for a day on yelp, before they filtered it out. All of this businesses’ reviews are filtered, no matter how active the reviewer. I guess they didn’t want to pay for yelp advertising. This is horrible when applied to a well performing business, but would be even worse if people trusted yelp for medical references.

  7. Kevin says:

    My primary doctor will readily admit that as much as 85 percent of his routine day could be performed by an NP or a PA. The remaining 15 percent of his cases usually require a specialist and get a referral. So, if that’s true, then primary healthcare is nothing more than expensive triage, right? Anyone who has ever served in the military will tell you that, when they got sick, the very first person they would see would be an enlisted person. In the military, you would need to be in very serious condition (near death) in order to see a doctor. I spent six year in the Navy and was sick several times. I never saw a doctor. I always saw a medic. In civilian life, a medic is a nurse. Evan makes a good point. We should insist that primary healthcare be staffed with more NP’s and PA’s and less expensive doctors. We should see more mega-clinics and less Marcus Welby type solo practices. We should operate healthcare like a Costco or a Walmart or a Home Depot. We should have primary healthcare and all of the specialties under one roof. I agree with Evan. Very Smart!

  8. evan says:

    That’s interesting Kevin. My primary care doctor tells me the same story. He calls his practice nothing more than a triage center where he does very little more than treat cuts and bruises, remove warts and refer the serious cases to specialists. He calls himself an over-educated nurse.

  9. Andrew says:

    For clarification, the patient satisfaction surveys being collected and published by these hospitals are independently administered and verified by a third party like Press Ganey, National Research Corporation or HealthStream (and usually submitted to the Centers for Medicare & Medicaid Services to comply with federal government regulations).

    These hospitals aren’t just “making up their own” patient ratings system. Technology companies like Digital Assent have recently developed technology platforms that enable hospitals to automatically publish 100% of these independently administered consumer satisfaction surveys to their own website / physician directory – to help make patient ratings and doctor selection more transparent.

    The problem with online review sites like Yelp is that they tend to only capture the “extreme voices” of a very small percentage of consumers who use a particular business or service. The number of reviews they have for any given physician is so small that it is statistically insignificant and, often, the reviews they collect are disproportionately negative because it’s the unhappy patients who are the most motivated to go inline after a bad experience and leave a negative review. Preventing fraudulent reviews is also a very big problem.

    I applaud University of Utah for being the first health system in the country to publish 100% of their consumer satisfaction scores (good, bad and ugly) and look forward to more hospitals following in their footsteps.

  10. Drew says:

    Attaboy Doc! Seems to me, in the extremely rare instance that you might have meningitis, then your need to see a whole host of specialists for your treatment, huh? However, if you need a wart removed, maybe you see a nurse, maybe not. Maybe you go to your local pharmacy and get some wart remover, huh? I’ll bet there’s way more cases of warts being removed than there are cases of meningitis, huh Doc? Duh! Just what we need, more dimwit doctors like we see posting here, huh? Duh!

  11. Mike says:

    Physician ratings are a positive thing for physicians. Measuring the results and service provided by a doctor will allow patients to make informed decisions. The top 3 web sites are a good measure of the previous service provided by a physician.

  12. steven says:

    According to one report, during the surveillance period between 1998 and 2007, the incidence of bacterial meningitis dropped from two cases per 100,000 people to 1.38 cases per 100,000 people. Gee, I wonder how many warts per 100,000 people got removed by over-educated doctors in that same period? Warts that could easily be removed by buying wart remover at your local pharmacy. FACT: Americans need to realize that an over-educated and expensive doctor is not needed for most primary care problems.

  13. Rick says:

    Isn’t “dimwit doctors” sort of an oxymoron? Let’s pause a moment before we bash the people who’ve dedicated 10+ years and 200,000+ dollars to studying and perfecting their field.

  14. Greg says:

    Let’s remember that a provider with a high satisfaction score doesn’t mean they’re providing good care. In fact, according to some studies, costs are higher with worse outcomes for these doctors doing whatever they think the patient wants. Also, I’m embarrassed for these “chief experience officers” at the big health care groups, this is why you went to medical school? To be Press Ganey’s little lackey and push a policy with no scientific merit?