Physician-Rating Websites vs Internal Patient Satisfaction Scores at a Large Cancer Center

A study published in JCO Oncology Practice found that internally generated patient satisfaction scores (internal scores) may paint a better picture for patients than physician-rating websites (PRWs), and that it may be in facilities’ best interest to make internal scores public to help patients decide on a facility or physician.

Gauging patient satisfaction with internal scores offers health care facility staff the opportunity to identify areas of strength as well as those that can be improved upon. PRWs, on the other hand, provide a public forum that informs patients who are looking for a physician. Each is potentially useful, but researchers set out to find out how the ratings given by patients compare on one platform versus the other.

PRWs and internal scores, which are generated using the Clinician and Group Consumer Assessment of Healthcare Providers and Systems (CG-CAHPS) survey, were collected at The University of Texas MD Anderson Cancer Center. Internal scores were linearly transformed into a star rating on a 5-point scale for the purpose of the study, and physicians were only included if they had 30 or more internal patient reviews.

Overall, 510 physicians were included in the analysis. Median numbers of reviews and scores from internal surveys and the 4 most commonly used PRWs (Google, HealthGrades, Vitals, and WebMD) were compared for the study.

The median number of internal scores was 49.5 (IQR; 30-93), and the median score was 4.89 (IQR; 4.81-4.93). On PRWs, the median number of reviews ranged from 2 to 7, with median scores ranging from 4.4 to 5. Given the larger pool of internal surveys versus PRWs, study authors suggest that patients may not realize the statistical downfalls of relying on a smaller number of reviews when making decisions.

A confounding factor might also be the difference in survey methodology between PRWs and internal scores, but patients reviewing the various PRW websites might not be aware of that distinction, the authors noted. PRWs do not always reflect a physician’s quality, possibly harming their reputation due to factors that have nothing to do with the patient-provider relationship, like parking, facilities, or interactions with office staff. The 8 validated questions from the CG-CAHPS used for internal surveys focus on the patient-provider relationship.

Study limitations included that fact that patient anonymity made it impossible to compare internal scores with PRWs written by the same reviewers to analyze demographics. Patients may also respond differently to surveys given by an institution than they would to an external PRW.

The study was originally undertaken to convince MD Anderson’s providers that publishing survey results online would help their reputations. Doing so also highlighted the importance of giving providers a chance to improve over time without being haunted by old reviews. In their system, they allow old reviews to roll off after 12 months. PRWs, on the other hand, often leave old reviews up indefinitely, even if a provider has gained experience and overcome a habit with training.

“In this study, we demonstrate the need to publish internal scores online to give patients more complete information regarding physician performance,” the authors concluded.

Reference

Kim C, Chisholm G, Bevolo A, et al. Comparison of internal patient satisfaction scores at a cancer center with star ratings on online physician-rating websites. JCO Oncol Pract. Published online March 24, 2021. doi:10.1200/OP.20.00564