Internet Ratings and Choice of Physician

By July 2, 2019 Commentary

Why consumers pick a particular doctor is fascinating to me.  And of course, consumers of different ages, genders, ethnic backgrounds and health status may have different approaches to their choice process.  A new study focuses on the effect of using an internet physician rating service on choice of doctor.   (JMIR Research)   Several types of characteristics could affect physician choice, including demographic characteristics, technical skill and interpersonal skills.  For privately insured patients, whether a doctor is in the plan’s network may also be a factor.  In addition, consumers may weigh some characteristics differently for primary care and specialist doctors.  The authors in this study looked at how ratings of technical and interpersonal skills affected selection of primary care or specialist physicians by about 540 consumers.  The subjects were randomized to 16 groups with different combinations of ratings and were given a sample situation in which they needed to find either a primary care doctor  or a surgeon to treat a specific medical issue.  They were then given internet ratings pages for 16 physicians, half primary care and half surgeons.  There were only four rating scores on the review pages; two related to technical skill and two to interpersonal ones.  Different doctors were given different combinations of ratings on the questions and the interpersonal and technical skill ratings were presented in different orders to different subjects.

In general, people were more willing to choose a specialist (the surgeon) with higher technical skills than interpersonal ones, than they were to choose a primary care doctor with the same set of characteristics, but people also tended to value technical skills more than interpersonal ones for all selection cases.  A primary care doctor who had high interpersonal scores but a lower technical rating was less likely to be selected than one with the reverse characteristics.  The use of internet ratings for doctors is complicated.  Why should one consumer trust other consumers’ ability to evaluate the technical skill of a doctor, or even their interpersonal abilities?  How well are ratings screened by the sites?  If the number of people posting reviews is high enough, perhaps an accurate trend can be established.  And shouldn’t we be somewhat concerned about consumers choosing interpersonal abilities over technical skills if we want the best outcomes for patients?  While a good interpersonal interaction may facilitate a better outcome, it isn’t a real substitute for a doctor who makes better diagnostic and treatment decisions or who is more skilled in actual procedures.  This research has clear utility for doctors trying to understand how to better attract new patients and keep existing ones, but policymakers should be a little concerned about whether these kind of consumer ratings are the best information for patients to use in making a physician selection.  It would be useful, for example, to compare internet ratings of physicians’ technical skills with more objective measures.

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