FEATURE
These sites provide a platform that did
not exist before, and allow patients to
comment in a way that is familiar to
them because it exists on so many other
consumer websites.”
When patients are dealing with one
of the many challenging conditions
treated by hematologists and oncologists,
the stakes for finding a good physician
are even higher, he said. Therefore, it is
important that patients, as well as physicians, are informed and educated about
these websites and the type of information they provide.
Emergence of Ratings Websites
Before the internet entered every corner
of our lives, word of mouth or referrals
were probably the most influential sources of good-quality information about
which physicians to visit, according to
Ritu Agarwal, PhD, Robert H. Smith
Dean’s Chair of Information Systems and
senior associate dean for Faculty and
Research at the University of Maryland
in College Park, Maryland.
“We all trusted our doctors, and if
our doctors recommended a pulmonologist or a cardiologist, we were more
than likely to believe them and go to that
specialist,” Dr. Agarwal said.
A little more than a decade ago
there was some basic information
about physicians online, mostly in the
form of insurance companies’ databases, she explained. Many companies
maintained demographic information
about physicians, as well as information about their level of experience,
their educational background, and
their board certification status.
That all changed in 2005 when, seemingly all of a sudden, physician-rating websites
started popping up. RateMDs.com was first,
appearing on the scene with physician
reviews, recalled Tara Lagu, MD, MPH,
assistant professor of medicine at the
Tufts University School of Medicine and
academic hospitalist in the Center for
Quality of Care Research and Department of Medicine at Baystate Medical, in
Springfield, Massachusetts.
“Within just a few years, a number
of new websites were launched and this
rating and ranking concept caused great
concern among physicians,” Dr. Lagu
said. Specifically, she remembers seeing articles in periodicals interviewing
physicians who had bad experiences with
these online ratings websites.
“One of the early concerns was that
patients – or anyone really – would be
able to go online and write reviews of
doctors. They could say whatever they
wanted, and doctors would not be able to
respond because of issues with confidentiality,” Dr. Lagu said.
In reality, most physician-rating
websites allow doctors to respond to
negative reviews – to acknowledge the
criticism, to address what they perceive
ASHClinicalNews.org
as a misrepresentation of the facts, or
to explain why the patient-reviewer had
such a negative experience – as long as
they comply with HIPAA regulations.
Per patient-privacy laws, doctors cannot
disclose any protected health information in the response because the (often
anonymous) reviewer has not given his
or her consent to do so; the fact that
the patient may have disclosed private
information in the initial review does
not give a doctor permission to do the
same in response.
The integrity of the information on
these websites has always been called
into question. As a result, in 2010, Dr.
Lagu and colleagues investigated the
quality of physician-rating sites. They
searched reviews on 33 physician-rating
websites between March 1 and June 30,
2009 to establish a random sample of 300
Boston physicians. More than 70 percent
of the physicians did not have a review
published online at the time; among
those with a review, 88 percent were
positive.2
“Although this online rating system
was a new thing, we found that, early on,
there were not a lot of reviews online,”
Dr. Lagu said.
But, Dr. Lagu noted, that didn’t mean
that consumers weren’t looking for
information about physicians. Shortly
after the study’s completion, Dr. Lagu
was contacted by a friend for a referral to
a good dermatologist. “She said she had
been looking and could not find this doctor anywhere, meaning she had looked
online for reviews but there weren’t any
out there,” Dr. Lagu said. “So, even back
as far as 2009, patients were adjusting the
way they looked for physicians.”
What Are Consumers Looking
For?
Since that 2010 study, Dr. Lagu said that
the number of physician-rating websites
has decreased from more than 30 to
about 17 or so, with a few clear leaders
emerging. Among the most visib