Physician Rating Websites: What Aspects Are Important to Identify a Good Doctor, and Are Patients Capable of Assessing Them? A Mixed-Methods Approach Including Physicians’ and Health Care Consumers’ Perspectives

Abstract

BackgroundPhysician rating websites (PRWs) offer health care consumers the opportunity to evaluate their doctor anonymously. However, physicians’ professional training and experience create a vast knowledge gap in medical matters between physicians and patients. This raises ethical concerns about the relevance and significance of health care consumers’ evaluation of physicians’ performance.ObjectiveTo identify the aspects physician rating websites should offer for evaluation, this study investigated the aspects of physicians and their practice relevant for identifying a good doctor, and whether health care consumers are capable of evaluating these aspects.MethodsIn a first step, a Delphi study with physicians from 4 specializations was conducted, testing various indicators to identify a good physician. These indicators were theoretically derived from Donabedian, who classifies quality in health care into pillars of structure, process, and outcome. In a second step, a cross-sectional survey with health care consumers in Switzerland (N=211) was launched based on the indicators developed in the Delphi study. Participants were asked to rate the importance of these indicators to identify a good physician and whether they would feel capable to evaluate those aspects after the first visit to a physician. All indicators were ordered into a 4×4 grid based on evaluation and importance, as judged by the physicians and health care consumers. Agreement between the physicians and health care consumers was calculated applying Holsti’s method.ResultsIn the majority of aspects, physicians and health care consumers agreed on what facets of care were important and not important to identify a good physician and whether patients were able to evaluate them, yielding a level of agreement of 74.3%. The two parties agreed that the infrastructure, staff, organization, and interpersonal skills are both important for a good physician and can be evaluated by health care consumers. Technical skills of a doctor and outcomes of care were also judged to be very important, but both parties agreed that they would not be evaluable by health care consumers.ConclusionsHealth care consumers in Switzerland show a high appraisal of the importance of physician-approved criteria for assessing health care performance and a moderate self-perception of how capable they are of assessing the quality and performance of a physician. This study supports that health care consumers are differentiating between aspects they perceive they would be able to evaluate after a visit to a physician (such as attributes of structure and the interpersonal skills of a doctor), and others that lay beyond their ability to make an accurate judgment about (such as technical skills of a physician and outcome of care).

Physician–patient shared decision making in the treatment of primary immunodeficiency: an interview-based survey of immunologists

“…Effective feedback methods can help improve how the physician and healthcare organization meet the patient's needs (NORC 2014). One study has shown that physicians and patients agree that patients can evaluate healthcare providers based on infrastructure, staff, organization, and interpersonal skills but are not able to effectively evaluate technical skills (Rothenfluh and Schulz 2017). In the instance of Medicare accountable care organizations, measures, feedback and auditing methods incentivize physicians to use SDM (CMS 2016).…”

Content, Quality, and Assessment Tools of Physician-Rating Websites in 12 Countries: Quantitative Analysis

“…Some studies suggest that there is a knowledge gap between doctors and patients related to medical knowledge [ 5 ], which makes it difficult for health care consumers to accurately evaluate a physician’s medical performance. A study by Rothenfluh and Schulz [ 15 ] reports further that physicians and health care consumers are indeed reflective of their own capabilities to assess certain care aspects, especially if highly technical. The findings from this study evidence, however, that only a minority of websites present technical or medical criteria (37/143, 25.9%) to be assessed by patients, which may be a reassuring finding for doctors.…”

“…The third section on information content consisted of 25 items covering information on the professional and educational background of the physician, practice access, and contact information, as well as personal data about the doctor. These indicators were developed iteratively; first, indicators were derived from a scoping review by Victoor and colleagues [ 14 ] and a study by Rothenfluh and Schulz [ 15 ] on aspects that were cited to be for patients when choosing a physician. In a second step, during the pretest, more information items were added until saturation was reached.…”

“…A fourth section of the codebook was dedicated to the scales or rating tools available on PRWs to assess a physician. An earlier study by Rothenfluh and Schulz [ 15 ] identified indicators that are, according to physicians and health care consumers, important to identify a good physician and assessable by patients. These indicators were developed based on Donabedian’s quality of care model [ 16 , 17 ] that subdivides care quality into dimensions of structure (infrastructure, staff, equipment, organization, and accessibility), process (technical and interpersonal skill of the physician), and outcome (results of the treatment) of health care.…”

To be continued ………Supporting physicians' lifelong learning

“…[79][80][81] Patients also progressively use their voice to evaluate their physicians on online physician rating platforms, which consequently have internationally expanded in popularity and use. [82][83][84] Ratings stretch from global statements describing physicians' professionalism to specific evaluations of physician's performance covering interpersonal manner and technical competence, as we presented in our findings. Patients however often confuse physicians' performance with system issues (staff, waiting time, location), reporting their intent to return or negative sentiment without justification, which may reduce credibility and hence physicians' willingness to accept the online feedback.…”