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Research Letter |

Public Awareness, Perception, and Use of Online Physician Rating Sites FREE

David A. Hanauer, MD, MS1; Kai Zheng, PhD2; Dianne C. Singer, MPH3; Achamyeleh Gebremariam, MS3; Matthew M. Davis, MD, MAPP4
[+] Author Affiliations
1Department of Pediatrics, University of Michigan Medical School, Ann Arbor
2School of Public Health, University of Michigan, Ann Arbor
3Child Health Evaluation and Research Unit, University of Michigan Health System, Ann Arbor
4Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor
JAMA. 2014;311(7):734-735. doi:10.1001/jama.2013.283194.
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Published online

Patients are increasingly turning to online physician ratings, just as they have sought ratings for other products and services. Much of what is known about these sites comes from studies of the ratings left on them.1 Little is known about the public’s awareness and use of online physician ratings, and whether these sites influence decisions about selecting a physician.

In September 2012, we surveyed a nationally representative sample of the US population about their knowledge and use of online ratings for selecting a physician for themselves. The survey used the Internet-based KnowledgePanel (GfK Custom Research North America). Internet-connected computers were provided at no cost to those without access. Pilot testing of the survey was conducted on a separate convenience sample to ensure validity of the questions.

Results were weighted as in prior published studies to approximate the US population based on age, sex, race/ethnicity, education, and census region. The response rate was determined using RR1 of the American Association for Public Opinion Research. Significant differences among groups were identified with χ2 analyses (2-sided P < .05) using Stata version 10 (StataCorp). This study was approved by the University of Michigan Medical School institutional review board, and the requirement for informed consent was waived.

The response rate was 60% (2137/3563). Respondents (weighted percentage in parentheses) included 1131 women (52%) and 1006 men (48%); 1557 respondents (68%) were white/non-Hispanic, 196 (12%) black, 237 (14%) Hispanic, and 147 (7%) other. There were 357 respondents (21%) aged 18 to 29 years; 585 (17%), 30 to 39 years; 662 (18%), 40 to 49 years; 333 (19%), 50 to 59 years; and 200 (26%), 60 years or older.

Fifty-nine percent of respondents reported physician rating sites to be “somewhat important” (40%; 95% CI, 36%-44%) or “very important” (19%; 95% CI, 16%-23%) when choosing a physician, although rating sites were endorsed less frequently than other factors, including word of mouth from family and friends (Table 1). Whether a physician accepted one’s health insurance was rated “very important” most frequently (89%; P < .001 vs all other options).

Table Graphic Jump LocationTable 1.  Importance of Factors in Selecting a Physician (N = 2137)a

Awareness of online physician ratings (65%; 95% CI, 61%-69%) was lower than for other consumer goods such as cars (87%) and non–health care service providers (71%; P < .001 vs all other options) (Table 2). Among those who sought online physician ratings in the past year, 35% (95% CI, 28%-43%) reported selecting a physician based on good ratings and 37% (95% CI, 29%-45%) had avoided a physician with bad ratings. For those who had not sought online physician ratings, 43% (95% CI, 36%-49%) reported a lack of trust in the information on the sites. Participants were also asked to consider the implications of leaving negative comments about a physician; 34% (95% CI, 31%-38%) had concerns about their identity being disclosed and 26% (95% CI, 22%-30%) were concerned about the physician taking action against them.

Table Graphic Jump LocationTable 2.  Awareness and Use of Rating Websitesa

Prior work has shown that few physicians are reviewed on rating sites.2 However, an analysis of one rating site demonstrated that between 2005 and 2010 there was an increase in the number of physicians rated and the number of ratings per physician.3 A 2012 study from London, England, reported that 15% of individuals were aware of physician rating sites and only 3% had ever used them,4 which was similar to 2008 rates reported in the United States.5 A 2013 study from Germany reported 32% awareness and 25% usage.6 Our study found higher rates of awareness (65%) for the US population with usage (23%) comparable with Germany.

Our study has several limitations including (1) a 60% response rate, (2) the possibility that an Internet-based survey selected a web-savvy population that was younger than most health care consumers, and (3) measuring a single time point may not capture rapidly changing trends. Nevertheless, rating sites that treat reviews of physicians like reviews of movies or mechanics may be useful to the public but the implications should be considered because the stakes are higher.

Section Editor: Jody W. Zylke, MD, Senior Editor.

Corresponding Author: David A. Hanauer, MD, MS, University of Michigan Medical School, 1500 E Medical Center Dr, Ann Arbor, MI 48109 (hanauer@med.umich.edu).

Author Contributions: Drs Hanauer and Davis had full access to all of the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis.

Study concept and design: Hanauer, Zheng, Singer, Davis.

Acquisition of data: Hanauer, Singer, Gebremariam, Davis.

Analysis and interpretation of data: Hanauer, Zheng, Gebremariam, Davis.

Critical revision of the manuscript for important intellectual content: Hanauer, Zheng, Singer, Gebremariam, Davis.

Statistical analysis: Gebremariam, Davis.

Administrative, technical, and material support: Hanauer, Singer, Gebremariam.

Study supervision: Hanauer, Zheng, Davis.

Conflict of Interest Disclosures: The authors have completed and submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest and none were reported.

Funding/Support: This research was conducted with the support of the C. S. Mott Children’s Hospital National Poll on Children’s Health (http://www.mottnpch.org), sponsored by the Department of Pediatrics and Communicable Diseases at the University of Michigan and the University of Michigan Health System.

Role of the Sponsor: The sponsors had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication.

López  A, Detz  A, Ratanawongsa  N, Sarkar  U.  What patients say about their doctors online. J Gen Intern Med. 2012;27(6):685-692.
PubMed   |  Link to Article
Lagu  T, Hannon  NS, Rothberg  MB, Lindenauer  PK.  Patients’ evaluations of health care providers in the era of social networking. J Gen Intern Med. 2010;25(9):942-946.
PubMed   |  Link to Article
Gao  GG, McCullough  JS, Agarwal  R, Jha  AK.  A changing landscape of physician quality reporting. J Med Internet Res. 2012;14(1):e38.
PubMed   |  Link to Article
Galizzi  MM, Miraldo  M, Stavropoulou  C,  et al.  Who is more likely to use doctor-rating websites, and why? BMJ Open. 2012;2(6):pii:e001493.
PubMed   |  Link to Article
Kaiser Family Foundation. 2008 Update on consumers’ views of patient safety and quality information. http://kaiserfamilyfoundation.files.wordpress.com/2013/01/7819.pdf. Accessed October 19, 2013.
Emmert  M, Meier  F, Pisch  F, Sander  U.  Physician choice making and characteristics associated with using physician-rating websites: cross-sectional study. J Med Internet Res. 2013;15(8):e187.
PubMed   |  Link to Article

Figures

Tables

Table Graphic Jump LocationTable 1.  Importance of Factors in Selecting a Physician (N = 2137)a
Table Graphic Jump LocationTable 2.  Awareness and Use of Rating Websitesa

References

López  A, Detz  A, Ratanawongsa  N, Sarkar  U.  What patients say about their doctors online. J Gen Intern Med. 2012;27(6):685-692.
PubMed   |  Link to Article
Lagu  T, Hannon  NS, Rothberg  MB, Lindenauer  PK.  Patients’ evaluations of health care providers in the era of social networking. J Gen Intern Med. 2010;25(9):942-946.
PubMed   |  Link to Article
Gao  GG, McCullough  JS, Agarwal  R, Jha  AK.  A changing landscape of physician quality reporting. J Med Internet Res. 2012;14(1):e38.
PubMed   |  Link to Article
Galizzi  MM, Miraldo  M, Stavropoulou  C,  et al.  Who is more likely to use doctor-rating websites, and why? BMJ Open. 2012;2(6):pii:e001493.
PubMed   |  Link to Article
Kaiser Family Foundation. 2008 Update on consumers’ views of patient safety and quality information. http://kaiserfamilyfoundation.files.wordpress.com/2013/01/7819.pdf. Accessed October 19, 2013.
Emmert  M, Meier  F, Pisch  F, Sander  U.  Physician choice making and characteristics associated with using physician-rating websites: cross-sectional study. J Med Internet Res. 2013;15(8):e187.
PubMed   |  Link to Article
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