MD Rating Sites: Current State of the Space and Future Prospects

By Ruth Given

Ruth Given has spent the last few months doing an exhaustive study of the physician ratings business. Ruth is an independent health economist and consultant who has in the past worked for Kaiser, the California Medical Association and Deloitte Consulting. We’re very happy to make her study available on THCB and the Health 2.0 Blog. You can download the full report at the end of this introductory article—Matthew Holt

The past few years have seen an explosion in growth of websites allowing patients to review/rate (usually rant or rave about) their health care providers. Recent mainstream media attention has focused on the rating of physicians, with over 30 such sites now operating. A few sites, including RateMDs and Healthgrades, have been around for a number of years, but several high profile initiatives were recently launched. Last fall, national health plan Anthem announced that it would be partnering with restaurant rater Zagat to allow its enrollees to rate their MDs online. And in April, Angie’s List, whose subscribers rate a wide variety of local service companies, began to include all types of health care providers, including physicians.

Physician reaction to these sites has been generally unenthusiastic; but there is currently very little MDs can do legally to stop patients from posting opinions about them online. While this approach to reporting on MD performance has its shortcomings, there is also a growing recognition of the importance of accounting for patient experience in evaluating quality of care. The federal government, through the Agency for Healthcare Research and Quality (AHRQ) is moving to collect patient experience-related feedback, such as that included in their annual consumer assessment of hospitals reports. An AHRQ/Consumer Assessment of Healthcare Providers and Systems survey tool on patients’ experience with physicians has also been developed and is currently in use in a number of settings.

Given the recent ramp-up in sites and their newly legitimized role, the future for online MD rating seems fairly rosy. But is this really the case?

What are reasonable expectations for the performance of specific sites and the overall space? Just because we’ve seen a flurry of activity and funding doesn’t mean that this trend has much staying power. The previous dot-com boom/bust cycle should make us wary of being taken in by the newest “new thing,” especially in the frequently over-hyped realm of health care online. The purpose of this informal analysis is to scope out the prospects for online MD rating space. I do this by considering three key questions:

1) What is the value (i.e., benefit, controlling for broadly defined “costs”) for the consumer/patient/user;

2) How fair are these sites to the MDs being rated (where fairness and accuracy of ratings are positively associated with value for the consumer); and

3) Where will the financial resources come from to support operation of these sites?

This last question is critical, not only because value/fairness alone will not ensure website survival if no one is willing to cover the costs, but because the actual source of underlying funding (e.g., advertising, other clients, and/or sponsors) may create an impression of bias, and reduce interest and traffic, ultimately dooming the site itself. While I have tried to be as thorough as possible in identifying MD rating websites and exploring the major issues, this is only a preliminary effort, not the definitive analysis on this space. In fact, I’m hoping that blog-publication will stimulate lots of feedback on my assessment of this space from those who know as much if not more than I do about this topic.

To download the report (PDF) click here

Comments

[Jeff Oster]

Rosy? No.

From a consumer standpoint, it may seem like ratings have value. But from a provider standpoint, I really see no value. I'm rated each and every day by each patient I see.

From a historical standpoint, I founded a rating service in 1996 called MedSurv. My goal was to try to create a kind of 'seal of good house keeping' for doctors. The project floundered for several years and finally died on the vine.

Until there's a universal mandate, I don't see rating services as a valid tool.