People put an incredible amount of trust in on-line rating systems. If an Airbnb host has a five-star rating, we expect that we can travel to the host’s home, go to sleep in one of his or her beds, and still be alive the next morning. Our trust grows as our actual experiences with products, services, and people correspond to what we read about them on the Internet.
If you can trust other Internet users to let you know if an Airbnb host is honorable - it makes sense that you can use their help with other sensitive choices like selecting a physician.
There are numerous websites or apps that allow patients to rate physicians, including Angie’s List, ZocDoc, and HealthGrades. However, Yelp really stands out as it allows users to post somewhat-anonymous rants, both good and bad, about businesses and business owners. Yelp wants its reviews to be “passionate and personal.” They ask for “a rich narrative, a wealth of detail, and a helpful tip or two for other consumers.” And, that is what they get.
According to Yelp, 21 million people used its app and 69 million people visited the site via mobile web during the first quarter of 2016. By the end of the quarter, Yelpers had written more than 102 million reviews. The number of Yelpers reviewing physicians varies around the country; but in large cities like New York, Los Angeles, Chicago, and Atlanta a physician can easily have over 100 unique reviews.
Yelp isn’t opt-in-only (Yelpers can add and then post reviews for previously unlisted businesses). Bad ratings can’t be removed by business owners, and better scores can’t be bought. All of this adds to the reliability of the reviews, according to Yelp. Yelp does provide information to business owners on how best to respond to a bad review, but physicians need to be cautious about what they post. (See the Washington Post’s article on why physicians may not want to respond publicly to patient complaints on Yelp.) The only consolation, it seems, for physicians concerned about being falsely accused of bad business practices or providing poor care is that the site uses an automated software to weed out fake reviews and unreliable reviewers.
I've spent a lot of time reading reviews of physicians on Yelp, and I’m pretty sure not all of them are fair. However, it’s not easy to discount a physician’s Yelp score when twenty reviewers give the same praise or identify the same problem.
As we move toward pay-for-performance and pay-for-quality compensation structures for physicians, I believe we can expect on-line reviews to play a role. Patient satisfaction survey results have long been incorporated into physician bonus programs. It makes sense that, at some point in the future, physicians’ bonuses will start being tied to how patients score them online. Whether or not we are ready for that now, physicians and physician practices all over the country need to be wary of their patients’ online feedback as more and more patients rely on this information when selecting a physician.