A look behind hospitals' new online physician reviews
A growing number of health systems have begun posting patient reviews of their physicians—good and bad—on their own websites. The move highlights transparency and helps divert attention from outside review sources that may utilize less measured and controlled approaches to soliciting input, sources say.
Intermountain Healthcare, a nonprofit health system based in Salt Lake City made the leap on July 31. The system includes 22 hospitals, 185 clinics and health insurance plans from SelectHealth. Other systems that have recently adopted online review processes include North Shore-LIJ Medical Group, University of Pittsburgh Medical Center, Cleveland Clinic and Rush University Medical Center.
At Intermountain, their motivation comes down to customer service. There’s nothing in it for the system’s leadership, says Susan DuBois, assistant vice president of physician relations and medical affairs, because the reviews only target the physicians as individuals, not the hospital.
“Our objectives, in general, are fairly simple: Engaging patients in making healthcare decisions,” she says.
Intermountain Healthcare’s review process
To get their patient reviews, the system developed nine Clinician and Group Consumer Assessment of Healthcare Providers and Systems-based (CG CAHPS) questions. A third-party calls patients and asks those questions in a scripted format, makes a star rating based on that feedback and reviews any comments.
Positive feedback can be used immediately while negative feedback is initially flagged for review by the health system, which warns the physician before the review goes online. Then, it gets posted, warts and all. Reviews are only considered unusable if they use vulgar language or compromise patient privacy, DuBois says.
That’s not always the end of it. There have been cases in which physicians challenged negative reviews, DuBois says. When that occurs, the system seeks to verify any issues described and follow up as appropriate with the patient or provider--while still maintaining the anonymity of the submitter.
Physicians have to gather 30 ratings before their reviews start to appear online.
Health system impacts
Intermountain Healthcare is seeing their physicians becoming more engaged and interested in patient satisfaction, and in learning from their feedback, DuBois says. “Not all physicians love this,” she concedes, “but most are embracing the trend.”
The health system itself does not use the feedback. They are recognizing those physicians who are receiving great reviews, but realize “there always has to be somebody in the lower group,” DuBois says. They simply provide those physicians with tools to understand their reviews and improve them if they are interested in doing so.
A more difficult question is what impact the reviews are having on consumers.
DuBois says the data are being accessed, but they have no measure of how it is or is not making a difference. One thing they do see: their physicians are now surfacing higher in Google searches, which they attribute to the star ratings and comments. That is likely having an impact, but the numbers are impossible to know, DuBois says.
Where the trend is headed
A recently released survey by Nuance Communictions suggests millennials will be increasingly driving a shift toward the use of the Internet and social media as major factors in healthcare decision making.
Among its findings: millennials are 54% more likely than baby boomers to search online for health information and sources prior to a visit, and they are 60% more likely to not share feedback directly with their providers, but to tell others or share on social media.
As a result, providers will need to be cognizant of what’s being said about them online and the importance of online scorecards, the data suggest.
Tony Oliva, MD, vice president and chief medical officer at Nuance, notes for now, most young millennials (70% of those aged 18-24) have routine healthcare needs and choose a primary care physician based on recommendations from family and friends—often staying with the family doctor.
However, “What is interesting,” Oliva tells Healthcare Dive, “is they may be doing a lot of the evaluation of doctors for their parents and grandparents.” When someone in the family goes to the hospital, someone else—often a millennial—goes online. “I think that is a real trend,” Oliva says.
He does see hospital online physician reviews as more valuable than those of sites such as Yelp! or Healthgrades, where there is a lack of control over who participates and what types of questions are being asked.
However, he also predicts hospitals’ online physician reviews will have limited impact on healthcare decisions due to limited consumer trust in the process and limited consumer value placed on patient ratings.
He suggests hospitals release straight information such as HCAHPS data and Press Ganey scores to back up any patient satisfaction ratings. “I’d rather see them go that direction and think it has potentially more value,” he says. If patients can easily research a physician’s complication rates vs. patient satisfaction rates, he believes that will be the game changer.