Physician rating websites, such as Vitals.com, Healthgrades, and Angie’s list, allow patients to rate and discuss physician quality in the same way that travel websites allow guests to review restaurants and hotels. The NHS in Britain has encouraged patients to rate their physicians online and popularity of physician-rating websites is growing significantly in the US. But some physician organizations, including the AMA, have opposed the development of these sites, arguing that patient identity cannot be confirmed, physicians will be unable to respond to negative comments because of confidentiality issues, and reviews will be excessively negative. At least one physician group has suggested that physicians make all patients sign a "gag order" stating they will not review their physicians online. In fact, patient reviews of physicians are positive more than 90% of the time, according to a new study published online in the Journal of General Internal Medicine. The study is the first to systematically examine whether these websites contain inflammatory or potentially damaging information about physicians.
Dr. Tara Lagu, a Tufts University School of Medicine Assistant Professor based at Baystate Medical Center in Springfield, MA, and colleagues examined reviews of 300 physicians on 33 different physician-rating websites and found that in addition to the positive tone of reviews, most criticism by patients (e.g., "not enough parking," "waiting too long") could be addressed without violating patient confidentiality. The authors say that the biggest hurdle to widespread use of these sites is not the risk of negative or inflammatory physician reviews but rather the poor quality of the sites. Reviews are relatively scarce, patients are unable to search by criteria that may be important to them (e.g., languages spoken by the physician), most sites do not allow side-by-side comparisons of physicians, and many sites have incomplete information about office locations and physician credentials.
Researchers also found that most sites allowed advertisements and many promoted health care products. Several sites allowed physicians to purchase profiles which led to more prominent or positive display of that physician without revealing that these profiles were paid advertisements. One site offered an expensive gift in exchange for writing reviews on 8 or more physicians. A few extremely positive reviews seemed to be written by physicians themselves.
"The medical establishment’s concerns about physician-rating websites may be unfounded." Lagu says. "This early snapshot seems to indicate that patients are almost uniformly positive about their physicians, and criticism is often constructive. In light of these findings and the sites’ rapidly growing popularity, the medical community should encourage our patients to use and improve these sites. Professional organizations should also consider advising physicians to reveal conflicts of interest and to refrain from posting positive reviews about themselves."
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