A Comparison of Online Physician Ratings and Internal Patient-Submitted Ratings from a Large Healthcare System
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Hawaii Permanente Medical Group, Kaiser Moanalua Medical Center, Honolulu, HI, USA; 2Harvard University, Cambridge, MA, USA; 3University of California–Los Angeles, Los Angeles, CA, USA; 4Boston University, Boston, MA, USA; 5Southern California Permanente Medical Group, Pasadena, CA, USA; 6Department of Clinical Science, Kaiser Permanente, School of Medicine, Pasadena, CA, USA; 7Department of Research and Evaluation, Southern California Permanente Medical Group, Pasadena, CA, USA.
BACKGROUND: Physician online ratings are ubiquitous and influential, but they also have their detractors. Given the lack of scientific survey methodology used in online ratings, some health systems have begun to publish their own internal patient-submitted ratings of physicians. OBJECTIVE: The purpose of this study was to compare online physician ratings with internal ratings from a large healthcare system. DESIGN: Retrospective cohort study comparing online ratings with internal ratings from a large healthcare system. SETTING: Kaiser Permanente, a large integrated healthcare delivery system. PARTICIPANTS: Physicians in the Southern California region of Kaiser Permanente, including all specialties with ambulatory clinic visits. MAIN MEASURES: The primary outcome measure was correlation between online physician ratings and internal ratings from the integrated healthcare delivery system. RESULTS: Of 5438 physicians who met inclusion and exclusion criteria, 4191 (77.1%) were rated both online and internally. The online ratings were based on a mean of 3.5 patient reviews, while the internal ratings were based on a mean of 119 survey returns. The overall correlation between the online and internal ratings was weak (Spearman’s rho .23), but increased with the number of reviews used to formulate each online rating. CONCLUSIONS: Physician online ratings did not correlate well with internal ratings from a large integrated healthcare delivery system, although the correlation increased with the number of reviews used to formulate each online rating. Given that many consumers are not aware of the statistical issues associated with small sample sizes, we would recommend that online rating websites refrain from displaying a physician’s rating until the sample size is sufficiently large (for example, at least 15 patient reviews). However, hospitals and health systems may be able to provide better information for patients by publishing the internal ratings of their physicians.
Prior Presentations This study has not been previously presented. Received January 31, 2019 Revised June 3, 2019 Accepted July 11, 2019
KEY WORDS: physician online ratings; physician online reviews; patient satisfaction. J Gen Intern Med DOI: 10.1007/s11606-019-05265-3 © Society of General Internal Medicine 2019
INTRODUCTION
Websites providing user-submitted ratings of goods and services have become ubiquitous and are commonly used by consumers to inform their decision-making. This trend has also spread to healthcare,1–14 as there are now dozens of publicly available websites d
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