Consumers care about both clinical and ‘patient experience’ ratings to choose primary care doctors

Patients pay equal attention to online ratings that measure a physician’s clinical ability as well as those that measure the patient experience, according to a new study.

Both factors are important to patients when choosing a primary care doctor, according to the study published in the Journal of Medical Internet Research.

Researchers conducted an experiment on a sample of 950 individuals who were asked to choose their primary care doctor from pairs of physicians with different ratings. Those ratings measured both clinical aspects of care as reported on the government’s Centers for Medicare & Medicaid Services (CMS) website and nonclinical aspects of care on commercial ratings sites such as Yelp, RateMDs, Healthgrades and Vitals. Nonclinical ratings were based on patient online reviews about their experiences with staff, nurses and doctors during a recent visit.

The study showed online nonclinical ratings were as important to patients as CMS’ clinical ratings, a finding that surprised lead author Niam Yaraghi, Ph.D., of the University of Connecticut and the Center for Technology Innovation at The Brookings Institution. Yaraghi said he expected that clinical ratings from CMS that rate a doctor’s medical expertise would play a more important role than the ratings on commercial sites that are based on patient reviews. But in fact, patients put great weight on those commercial web sites.

Those commercial ratings were even more important for female patients who perceive online ratings to be more important than clinical ratings from the government site.

“This may be due to the fact that patients are so used to online ratings for everything else from restaurants and movies to Amazon products. Their previous good experiences with those types of ratings leads them to rely on such ratings for doctors as well,” Yaraghi said, in an email to Fierce Healthcare.

That’s good news for online rating sites because it shows their services are being used by patients despite the competition from CMS, he said. On the other hand, the research may give CMS pause to rethink its Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS), a patient satisfaction survey of patient experiences that measure nonclinical aspects of care. “They either have to find ways to make their ratings more accessible to patients and persuade them to use them or just delegate the task of rating providers to online websites such as Yelp,” Yaraghi said.

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While CMS has used controversial star ratings on its Hospital Compare website for some time, the government agency late last year began displaying physicians’ 2016 performance data as star ratings on the Physician Compare website’s profile pages. The agency also added new quality measures that allow patients to compare data on doctors.

And given the importance of nonclinical ratings in patients’ decision making, the researchers said medical providers should pay close attention to their ratings on commercial websites. They are a source of patient feedback that providers can use to improve the patient experience, the study concluded.

A separate study released this month found a disconnect between doctors’ clinical ability and online patient ratings. The study found urologists with a higher patient volume have lower online patient ratings, likely the result of longer wait times and less time spent with patients.

While online reviews are an increasingly popular tool for patients to evaluate and choose physicians, studies have called into question their usefulness in judging a doctor’s clinical ability. Doctors and patients have different views on whether independent or health system physician rating websites are the more reliable source of information, and they disagree about whether the data should be shared on public websites.