Picking a Physician? Don’t Rely on Online Reviews

If you have a chronic disease, relying on review websites for choosing a doctor could be hazardous to your health.

Based on the research of Indranil Bardhan

These days, when people need an auto mechanic, they often check out online reviews. When they need a doctor, it seems natural to do the same.

A 2019 survey found 90% of patients consulted review websites such as Yelp, Healthgrades, and Vitals before choosing a doctor. For 71%, it was their first step.

Numbers like those raised eyebrows for Indranil Bardhan, professor of information, risk and operations management at Texas McCombs. He wondered: How reliable are online reviews for predicting the quality of care a patient might receive?

In new research, with Danish Saifee of the University of Alabama and Zhiqiang Zheng and Atanu Lahiri of The University of Texas at Dallas, Bardhan finds that online review sites of physicians are not trustworthy — at least not for patients with chronic conditions such as diabetes or chronic obstructive pulmonary disorder.

For the study, the researchers collected reviews and ratings of physicians from Vitals.com. They compared them against data from the Dallas-Fort Worth Hospital Council Research Foundation, a trade organization for hospitals in North Texas, with respect to the clinical health outcomes of COPD patients who were treated by those same doctors.

Unfortunately for consumers shopping for a doctor, the study found that glowing reviews did not guarantee good outcomes. A highly-rated physician was just as likely to provide below-par health outcomes.

Bardhan, the Foster Parker Centennial Professor in Information Technology, recently explained his findings, their lessons for consumers, and the need for health care systems to make data more accessible so that patients can make crucial medical decisions.

What got you interested in online physician reviews?

In the retail field, there’s been a lot of research looking at the relationship between product reviews and sales or market share. In the health care industry, there hasn’t been much research on how well reviews reflect quality of care. Often, potential patients are making decisions in a vacuum. They’re looking at reviews from prior patients, but they don’t see the clinical outcomes for those patients.

What little research has been done has looked mostly at surgery. In that context, it found there actually was a significant linkage between reviews and patient outcomes. But there was no research on chronic diseases.

How is reviewing a surgeon different from reviewing a chronic care doctor?

A non-chronic disease has a discrete endpoint. If you have knee surgery, the outcome is very clear. If you are pain-free, it is likely that your surgery went well. If you’re still in pain, your surgeon probably did not do a good job.

Chronic diseases are ones for which you have no cure. Once you have diabetes or COPD or congestive heart failure, you have to manage it for the rest of your life. Because there’s no discrete outcome, it’s harder for the patient to evaluate the quality of their physician.

What you often find, instead, is that patients review their doctors based on other factors such as their bedside manners, their appearance, or the cleanliness of their office. All that has nothing to do with the health outcomes that the patient may experience.

What kinds of outcomes did you look at?

We looked at clinical data on readmission rates, on whether a patient is readmitted within 30 days. That’s a standard measure for health care quality, used by the Centers for Medicare & Medicaid Services and many insurance companies.

We wanted to evaluate whether better ratings by patients translated into lower readmission rates. But our study found absolutely no connection.

Where does that leave patients with chronic diseases? If online reviews aren’t helpful for picking a doctor, can they go somewhere else to find information on outcomes?

I’m afraid there’s no easy way for the average person to find that out for individual physicians. There are various websites where they can find readmission rates for hospitals, but since there may be hundreds of doctors working at a hospital, it is bad news for patients.

Is there any way to get better information to medical consumers?

We’ve made some policy prescriptions. Hospitals could make more data available publicly on the quality of individual doctors. They could track some key health metrics. For a cardiologist or a cancer specialist, for example, they could provide hospital readmission and mortality rates, as well as patient quality of life measures.

So to sum up, if you’re facing heart surgery or knee replacement, you can put some faith in online reviews. But if your problem is diabetes or COPD, take them with a grain of salt.

That’s right. If you’re selecting a physician for a chronic disease based only on these online reviews, you’re as likely to be making a poor decision as a good one.

“Are Online Reviews of Physicians Reliable Indicators of Clinical Outcomes? A Focus on Chronic Disease Management” is published in Information Systems Research, December 2020.

Story by Steve Brooks