When looking for a doctor, many consumers turn to websites that post physician ratings and reviews. A study at Hospital for Special Surgery (HSS) found a discrepancy between doctor reviews provided by hospital websites and those posted on independent physician rating websites such as Healthgrades.com and Vitals.com.

Investigators found a much higher number of reviews and more favorable physician ratings overall on the hospital websites. The research was presented today at the American Academy of Orthopaedic Surgeons Annual Meeting in New Orleans. The study was also published in the journal Orthopedics in August 2017.

Consumer-driven healthcare and an increasing emphasis on quality measures have encouraged patient engagement in the rating of doctors and the care they provide. Independent commercial physician rating websites such as Healthgrades.com have become a popular outlet for patients to express their satisfaction or dissatisfaction.

A number of hospitals and medical practices have also started to publicly report the results of their own patient satisfaction surveys, which are often administered by a third party such as Press Ganey.

"The purpose of our research was to compare overall patient satisfaction ratings for orthopedic surgeons derived from hospital surveys with those posted on commercial physician rating websites. We also sought to determine which physician characteristics resulted in higher ratings," explained Bradford Waddell, MD, an orthopedic surgeon at Hospital for Special Surgery.

The study included 12 hospitals or medical practices that were publicly reporting patient satisfaction data collected for their orthopedic surgeons as of August 2016. Investigators identified 415 orthopedic surgeons with online patient ratings at the following institutions: Duke University, Midwest Orthopedics at Rush, Vanderbilt University, Northwell Health, Cleveland Clinic, University of Utah, University of Arkansas, Stanford University, University of Pittsburgh, Wake Forest University, Southern California Orthopedic Institute and Piedmont Healthcare.

The hospital surveys were administered at the time of the office visit or sent to randomly selected patients by email or regular mail. Independent third parties experienced in the creation and evaluation of health care surveys were used by most hospitals to gather the information. Patient response rates ranged from 18 percent to 30 percent. Most institutions required a minimum of 30 ratings within the past 12 to 18 months for the physician’s ratings to be made public.

For each orthopedic surgeon, the type of institution (academic setting versus private practice), sex, years in practice, geographic location and subspecialty training were recorded. The number of individual survey questions ranged from 6 to 20, depending on the institution, and most included questions on communication, trust in provider decision-making, time spent with the patient and willingness to recommend the physician to others. At all of the hospitals, an overall physician rating was reported on a scale of 1 to 5, with 5 as the highest rating.

Most of the institutions had a stated policy of publishing all physician ratings, including negative reviews and comments, as long as no offensive, profane, or slanderous remarks were made and there was no violation of patient privacy or confidentiality.

Researchers compared the ratings reported for each doctor posted on the hospital websites with the physician’s ratings on four commercial websites: Healthgrades.com, Vitals.com, RateMDs.com and UCompareHealthCare.com.

"Compared to commercial ratings websites, we found that provider-initiated patient satisfaction surveys yielded a higher number of ratings for each doctor, higher average patient satisfaction scores and a lower percentage of negative comments," said Alexander McLawhorn, MD, an orthopedic surgeon at HSS. "We saw a small association between increased years in practice and the likelihood of a negative rating, while academic practice settings and those in the Northeast had a lower percentage of negative comments."

"While hospital surveys are distributed to patients who received care from a specific doctor, ratings on sites such as Healthgrades and Vitals are often anonymous, and you really don’t know who is posting a review," Dr. Waddell noted. "We believe hospital surveys filled out by patients provide data of a higher quality and are a better indication of patient satisfaction."

Feedback from patients can also provide valuable information to physicians, according to Dr. Waddell, who believes increasing the use and reporting of patient satisfaction surveys could benefit the orthopedic community. "In contrast to a limited number of random online reviews, healthcare provider surveys can gain insights from a much larger population of patients. The more information we have, the more we can improve patient care."