Patients are turning to sources such as ZocDoc, HealthGrades, Vitals, Yelp and other online physician review sources, and reviews are impacting where patients seek care. A 2019 survey conducted by Software Advice found that 72% percent of respondents used online reviews as a first step in seeking a medical provider. While this percentage may appear shockingly high to some, it accurately reflects our nation’s current consumer landscape. With similar models for selecting restaurants, clothing, cars, and other retail businesses, it was only a matter of time until the healthcare industry followed. Understanding what these online reviews say — and don’t say — can help your practice develop a strategy for improving these reviews and aid you in developing a positive reputation online.
Patient-Centered Physician Reviews are Not New
The concept of being rated on patient satisfaction is not inherently novel. The Clinician and Group Consumer Assessment of Healthcare Providers and Systems (CG-CAHPS) survey asks patients to reflect on the care they received in the ambulatory setting of primary or specialty care practices. Since 1998, the CAHPS Health Plan Survey Database has collected over 5.6 million surveys. Similarly, the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) asks patients to discuss their hospital experiences from admission to discharge. As one of the measures in the CMS Hospital Value-Based Purchasing (VBP) Program initiative, HCAHPS affects a physician’s total Medicare reimbursement, while the CG-CAHPS was incorporated into the Physician Quality Reporting System (PQRS) through the 2016 program year. The Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) replaced PQRS with the Quality Payment Program (QPP) and the Merit-based Incentive Payment System (MIPS), which will use collected data — including patient satisfaction measures — to adjust Medicare payments either up or down beginning in 2019.
While it’s unclear whether online physician reviews in sites like ZocDoc and Healthgrades will one day affect physician reimbursement, recent developments suggest that it's possible. For example, United Healthcare is incorporating Healthgrades’ patient satisfaction data and reviews into their online physician directory for policyholders to choose their physician. Linking these to provider reimbursement or network availability is a logical next step.
What Do Online Physician Reviews Really Say?
With patients using reviews to help them select physicians, it’s worthwhile to understand what these reviews say — and don’t say — about the physicians being reviewed.
A study published in Journal of the American Medical Informatics Association titled “Online Physician Ratings Fail to Predict Actual Performance on Measures of Quality, Value, and Peer Review” found that “across ratings platforms, multivariable models showed no significant association between mean consumer ratings and specialty-specific performance scores.” Similarly, a study by Vanguard Communications that analyzed 34,748 online physician reviews found that only 4% of complaints in reviews were related to the medical care received, with the remaining 96 percent of patient complaints related to general customer service issues. The Vanguard study identified the following as the top customer service complaints and compliments:
Top Customer Service Complaints:
- Communication (53%)
- Wait times and waiting rooms (35%)
- Practice staff (12%)
Top Customer Service Compliments in Five-Star Reviews:
- Bedside manner (40%)
- Practice staff (28%)
- Communication (24%)
Strategies for Encouraging Positive Physician Reviews
As the data above shows, reviews often center on communication or staff and physician disposition, not clinical knowledge or technical skill. This suggests that prudent physicians have an opportunity to become more proactive in maximizing patient satisfaction and improving their reviews.
Regardless of how professional or qualified a provider or staff member may be, there will always be a dissatisfied patient, even among a sea of those pleased. While you can’t account for all instances where a patient or provider simply had a bad day, here are several strategies you can employ to improve or encourage positive reviews.
1. Create Profiles on Physician Review Sites
Providers may naturally be resistant to the idea of reviews being available online and may be concerned by the prospect of patients selecting their physician based on online reviews. Regardless of a provider’s thoughts regarding whether or not reviews should be available online, the reviews are likely here to stay. The first step in establishing an environment for positive patient feedback is initiating profiles on the major physician review sites such as ZocDoc, HealthGrades, Vitals, Yelp and others. Knowing the staggering number of patients who are using this data to establish care means providers are alienating a potential patient population if they are unwilling to get in the game. Acknowledging this fact is the first step in utilizing it to your advantage.
2. Be Proactive About Addressing Patient Concerns
If a patient has a negative experience at your clinic, address the issue the same day if possible. Work with your front office staff and check-out team to routinely ask each patient how their experience was and how it could have been better for them. If the patient responds with a criticism, ask if they would be willing to be contacted by the physician or practice manager to address their concerns. This allows for ongoing practice pattern improvement, which leads to greater patient satisfaction and more positive reviews, and aids in curbing negative reviews because the patient will recognize that your staff cares about them and desires to improve their patient experience.
3. Be Bold and Consistent in Asking for Reviews
After establishing an online profile, the first step in receiving an online patient review is simply asking the patient to leave a review. This task alone can be daunting. Physicians may wonder, What if the patient had a negative experience? However, you may be surprised how many patients are willing to complete the survey because you took the time to personally ask them to do so. And, if you've been proactive in asking patients about their experiences and work to resolve any issues that arise, patients will be more willing to leave a positive review because they'll know your practice is making efforts to improve their experience.
4. Provide Easy Ways for Patients to Leave Reviews
The simpler the process of reviewing is for patients, the more likely they are to do it. It's easy to include a small card with a patient’s after-visit summary or a note printed on it with instructions on how to leave a review. Ask your check-out team to draw attention to this at check out. Do your patients receive normal lab results or imaging reports via a patient portal? Consider including a direct review link in your signature line to encourage your patients to leave a review.
Offices also usually have dead-time where patients are waiting on billing, scheduling their next appointment, or getting printouts for prescriptions. Strategically incorporating this dead-time into active time where a patient could quickly complete a review on their phones or a practice-provided tablet could prove useful while also minimizing perceived wasted time by the patient.
Different strategies may work better than others for different practices or patient populations. Try using several strategies initially to see which best fits your practice. After deciding which approach is best, focus your efforts there to solicit reviews.
5. Develop a Strategy for Negative Reviews
Regardless of the caliber of care you provide your patients, physicians should expect an occasional negative review. For many physicians, though, it’s easy to focus only on the negative reviews received among a sea of positive reviews. Some sites will allow you to remove or edit negative reviews, especially if the patient did not actually visit your practice. Before completing your profile for online reviews, review the site’s policy regarding deleting reviews.
Providers may also take the approach of responding directly to the negative review. In fact, the same survey by Software Advice cited above found that 65% of patients believe responding to a negative review is “very important” or “moderately important.” If you decide to respond, remember that your response becomes part of your online reputation. Follow group practice guidelines if you’re part of a group practice and don’t directly or personally attack the individual posting the comment.
Remember, also, that HIPAA compliance standards are still in place, even in this forum. Always maintain compliance with federal and state privacy laws. Here are some more tips for formulating a response:
- Use neutral, professional language.
- Thank the reviewer for providing feedback.
- Stress that a great patient experience and patient satisfaction is of paramount importance to you.
- If appropriate, detail any practice changes the review may have initiated.
- Without acknowledging that the reviewer was or was not a patient, request that they contact the office if they have specific questions.
Practices may want to designate an individual in their office who is responsible for taking inventory of reviews weekly or monthly. In addition to compiling information regarding how to improve patient satisfaction, this person may also reach out to dissatisfied reviewers to discuss their experience with them directly.
While you may not be able to eliminate negative reviews completely, using a consistent strategy of soliciting positive reviews will drown the negative voices and create an overall positive online reputation for you and your practice.
Software Advice. “How Patients Use Online Reviews.” 2019. (accessed 3/27/2018)
Agency for Healthcare Research and Quality (AHRQ):
- “CAHPS®: Assessing Health Care Quality from the Patient’s Perspective.” March 2016. (accessed 6/7/2018)
- “The CAHPS for Physician Quality Reporting System (PQRS) Survey.” February 2017. (accessed 6/7/2018)
Centers for Medicare and Medicaid Services (CMS). “Hospital Value-based Purchasing.” September 2017. (accessed 6/7/2018)
Kerri Wing. “A Guide to Reporting on MACRA in 2018.” February 9, 2018. Physicians Practice. (accessed (6/7/2018)
Susanne Madden. “Online Reviews: Payers Are Paying Attention Too.” January 31, 2018. Physicians Practice. (accessed 6/7/2018)
Timothy J Daskivich, et al. “Online Physician Ratings Fail to Predict Actual Performance on Measures of Quality, Value, and Peer Review.” Journal of the American Medical Informatics Association, Volume 25, Issue 4, 1 April 2018, Pages 401–407. (accessed 6/7/2018)
Vanguard Communications. “Doctor Complaints Online? Blame Customer Service, Not Doctors’ Care.” (accessed 6/7/2018)