Organizations See Benefits of Posting Patient-Generated Physician Ratings

Leading provider organizations are posting their own physician-specific ratings and reviews online, confident that the information is more accurate, more meaningful—and more positive—than that posted by independent review companies.

The list of health systems that post their patients’ ratings and reviews of physicians online is growing: Duke University, Vanderbilt University, Northwell Health, Cleveland Clinic, University of Pittsburgh Medical Center (UPMC), and more. And they are finding that those reviews are a more accurate reflection—and are more positive—than the information being published by physician-rating websites.

That’s the finding of a comparison conducted by Benjamin F. Ricciardi, MD, an orthopedic surgeon at University of Rochester Medical Center, and colleagues. “Provider-initiated internal patient satisfaction ratings showed a greater number of overall patient ratings, higher overall patient satisfaction ratings, and a lower percentage of negative comments compared with commercial online physician rating websites,” the authors wrote in the journal Orthopedics.

The researchers considered the ratings and reviews of 340 orthopedic surgeons at 12 health systems that publicly post their physicians’ ratings and reviews, comparing them with those posted by Healthgrades, Vitals.com, UCompareHealthCare, and RateMDs. On a scale of 1 to 5, the surgeons’ overall rating from their Press Ganey or other internally generated patient-satisfaction surveys was 4.7, which was significantly higher than the average on any commercial site. Similarly, the percentage of negative comments in the internal data was significantly lower.

Most importantly, provider-initiated ratings are more accurate simply because they are based on a much higher number of patient responses. While unhappy patients may be motivated to share their concerns on a commercial-rating website, health systems proactively ask their patients to respond to patient-satisfaction surveys. That means satisfied patients are more likely to share their perspective, giving a fuller picture of patients’ satisfaction with a given physician.

Physicians are generally unaware of how the commercial websites collect patient feedback. “We don’t really know where they get their information, or how it’s processed, or what the process is for posting comments,” says Lawrence Wechsler, MD, chairman of the neurology department at UPMC. “For each institution to do their own ratings is probably the best way to go. Then [physicians] understand what the process is, and everyone can weigh in on the fairness of the process.”

What Physicians Think

University of Utah Health pioneered the public posting of physicians’ Press Ganey scores in 2012. “We were all a little nervous,” says Jennifer Majersik, MD, MS, associate professor of neurology.

Six years later, the ratings and reviews serve as free advertising—and physicians who do not yet meet the criteria to have their ratings posted feel they are missing out.

“We require providers to have 30 surveys before their reviews get posted, but in the last two years, lots of providers who have not met that threshold have come to me and said, ‘I don’t care if I don’t have 30 surveys. I want my reviews online,’” says Kristen Mauck, senior business analyst in the Patient Experience and Value Engagement Department at University of Utah Health.

That’s because physicians know that patients are using the information as they search for providers. “People have choices,” Majersik says. “If you’re going to schedule between Dr. Jones and Dr. Smith and Dr. Patel, and you see Jones has no comments and Smith and Patel have great comments, you’re probably not going to go to the one with no comments.”

Patients are eager for information that helps them evaluate their choices. “We’ve all had the experience of patients coming in and commenting on our ratings, so it seems clear that patients actually read the comments,” UPMC’s Wechsler says.

Success Factors

Although physicians increasingly are becoming comfortable with having their internally generated ratings and reviews posted publicly, it’s still a relatively new concept that makes many providers nervous. Mauck and Brandon Swensen, manager for University of Utah Health, said a methodical approach to implementing the process is essential.

Go slowly. “We did a tremendous amount of pre-work in terms of changing culture at the University of Utah before going online” with physician ratings, Swensen says. “We had first spent years on our patient experience initiative.”

While many physicians were still nervous about online posting, they understood the intent and the process. Swensen has observed other health systems that started online ratings as an early step in their work to improve the patient experience—and received more pushback from physicians.

Get physicians involved. The health system’s CMO and division chiefs provided input into University of Utah Health’s protocol for public posting of comments and the process by which physicians can appeal.

Be clear about the purpose. Because public reviews are still new to the healthcare industry, physicians need to understand the health system’s motivation. University of Utah Health’s message is that making the most accurate information available counters the questionable information on commercial websites. “Our biggest message is that this is to protect them, not to market them or create more business,” Swensen says.

Create exemption criteria and an appeal process up front. The university collects approximately 400 comments about physicians via patient satisfaction surveys each week, and about 99 percent of those comments are posted online, Mauck says.

The vast majority of unposted comments fall into one of the exemption categories, meaning they revealed a patient’s personal information or were not specific to the care provider. 

In the past year, more than 20,000 comments have been made and only 10 physicians have requested appeals to the ambulatory executive committee, which is made up entirely of physicians.

“It’s a peer group that makes those decisions, so that removes us from that process,” Swensen says.

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Lola Butcher writes about healthcare business and policy topics for several HFMA publications.

Interviewed for this article:  Jennifer Majersik, MD, MS, associate professor of neurology, University of Utah School of Medicine, Salt Lake City; Kristen Mauck, senior business analyst, Patient Experience and Value Engagement, University of Utah Health, Salt Lake City; Brandon Swensen, manager, University of Utah Health, Salt Lake City; Lawrence Wechsler, MD, chair, Department of Neurology, UPMC, Pittsburgh.