What do patients say about doctors online?

Whether it’s deciding where to eat or what car to buy, people increasingly turn to online reviews to learn more before they make a purchase. The same applies for health care, with patients sharing their experiences with physicians, which others use to make decisions on where to seek care. The importance of patient online reviews (PORs) in medical decision making and opportunities they present for patient-provider communication has led to many studies of PORs. However, to date there has been no review of the entire body of research on PORs.

In a new study published in the Journal of Medical Internet Research, Y. Alicia Hong, PhD, associate professor in the Health Promotion and Community Health Sciences Department at the Texas A&M School of Public Health, and colleagues from Texas A&M University and the University of South Carolina, conducted a systematic review of research on PORs. In this work, the researchers examined the characteristics, methods and findings of more than 60 studies of PORs. They also identified research trends and areas needing more study and made recommendations for future research.

Hong and colleagues carried out an extensive literature search, looking for peer-reviewed studies focused on PORs of physicians or hospitals. Their search yielded 63 studies dating back to 2009, most of which were published after 2015 and conducted in the United States. The researchers analyzed these studies, including study design and major findings.

The researchers found that more than 40 percent of the studies reported average POR scores, which were mostly positive at roughly four on a one-to-five scale. However, they also found that PORs covered a relatively small number of physicians and hospitals, had widely ranging review totals and focused more on specialists, especially surgeons.

Several studies noted that PORs correlated well with traditional patient surveys. Some analyses of PORs led to new domains of patient experiences not covered by traditional patient surveys. A small number of studies examined the relationship between PORs and clinical outcomes, and overall such a relationship was weak.

“Research on PORs is growing rapidly, but that growth is outpaced by that of PORs themselves, thus more high-quality studies are needed,” Hong said. To that end, Hong and her and colleagues made several recommendations to improve future research.

They noted that studies should use larger samples and focus more on rural health care providers and organizations like nursing homes that serve people underrepresented in PORs. They also identified a need for more in-depth empirical research on how PORs affect consumer behaviors and on the effects of consolidating PORs onto a handful of commercially operated review sites.

Hong and colleagues also noted that PORs can affect health care practice and policy. They stated that health care providers should not dismiss PORs and recognize the power they have for communication and getting timely feedback to maintain patient satisfaction.

On the other hand, the researchers noted a need for POR website operators to improve identity verification methods, better handle abusive comments and misinformation and develop a consistent scheme for rating health care providers.

PORs are a rapidly evolving tool for health care consumers and providers alike.

“Current research has unearthed many details on PORs, and future research will be needed to gain a clearer picture of the POR landscape,” Hong said. “With more information, POR site operators, health care providers and consumers can work to further enhance this tool, which could lead to better patient satisfaction and quality of care.”

Other authors of this study from Texas A&M included Tiffany Radcliff, PhD, from the Health Policy Management Department, Lisa Wigfall, PhD, from the Health and Kinesiology Department, and Richard Street, PhD, from the Communication Department. Chen Liang, PhD, from the University of South Carolina School of Public Health, was also an author.