Online physician ratings fail to predict actual performance on measures of quality, value, and peer review

J Am Med Inform Assoc. 2018 Apr 1;25(4):401-407. doi: 10.1093/jamia/ocx083.

Abstract

Objective: Patients use online consumer ratings to identify high-performing physicians, but it is unclear if ratings are valid measures of clinical performance. We sought to determine whether online ratings of specialist physicians from 5 platforms predict quality of care, value of care, and peer-assessed physician performance.

Materials and methods: We conducted an observational study of 78 physicians representing 8 medical and surgical specialties. We assessed the association of consumer ratings with specialty-specific performance scores (metrics including adherence to Choosing Wisely measures, 30-day readmissions, length of stay, and adjusted cost of care), primary care physician peer-review scores, and administrator peer-review scores.

Results: Across ratings platforms, multivariable models showed no significant association between mean consumer ratings and specialty-specific performance scores (β-coefficient range, -0.04, 0.04), primary care physician scores (β-coefficient range, -0.01, 0.3), and administrator scores (β-coefficient range, -0.2, 0.1). There was no association between ratings and score subdomains addressing quality or value-based care. Among physicians in the lowest quartile of specialty-specific performance scores, only 5%-32% had consumer ratings in the lowest quartile across platforms. Ratings were consistent across platforms; a physician's score on one platform significantly predicted his/her score on another in 5 of 10 comparisons.

Discussion: Online ratings of specialist physicians do not predict objective measures of quality of care or peer assessment of clinical performance. Scores are consistent across platforms, suggesting that they jointly measure a latent construct that is unrelated to performance.

Conclusion: Online consumer ratings should not be used in isolation to select physicians, given their poor association with clinical performance.

Publication types

  • Observational Study

MeSH terms

  • Attitude to Health
  • Clinical Competence*
  • Data Accuracy*
  • Humans
  • Internet
  • Medicine
  • Patient Satisfaction*
  • Peer Review
  • Physicians* / standards
  • Quality Assurance, Health Care / methods
  • Quality of Health Care*