Abstract
BackgroundHealth care consumers are increasingly using online ratings to select providers, but differences in the distribution of scores across specialties and skew of the data have the potential to mislead consumers about the interpretation of ratings.ObjectiveThe objective of our study was to determine whether distributions of consumer ratings differ across specialties and to provide specialty-specific data to assist consumers and clinicians in interpreting ratings.MethodsWe sampled 212,933 health care providers rated on the Healthgrades consumer ratings website, representing 29 medical specialties (n=128,678), 15 surgical specialties (n=72,531), and 6 allied health (nonmedical, nonnursing) professions (n=11,724) in the United States. We created boxplots depicting distributions and tested the normality of overall patient satisfaction scores. We then determined the specialty-specific percentile rank for scores across groupings of specialties and individual specialties.ResultsAllied health providers had higher median overall satisfaction scores (4.5, interquartile range [IQR] 4.0-5.0) than physicians in medical specialties (4.0, IQR 3.3-4.5) and surgical specialties (4.2, IQR 3.6-4.6, P<.001). Overall satisfaction scores were highly left skewed (normal between –0.5 and 0.5) for all specialties, but skewness was greatest among allied health providers (–1.23, 95% CI –1.280 to –1.181), followed by surgical (–0.77, 95% CI –0.787 to –0.755) and medical specialties (–0.64, 95% CI –0.648 to –0.628). As a result of the skewness, the percentages of overall satisfaction scores less than 4 were only 23% for allied health, 37% for surgical specialties, and 50% for medical specialties. Percentile ranks for overall satisfaction scores varied across specialties; percentile ranks for scores of 2 (0.7%, 2.9%, 0.8%), 3 (5.8%, 16.6%, 8.1%), 4 (23.0%, 50.3%, 37.3%), and 5 (63.9%, 89.5%, 86.8%) differed for allied health, medical specialties, and surgical specialties, respectively.ConclusionsOnline consumer ratings of health care providers are highly left skewed, fall within narrow ranges, and differ by specialty, which precludes meaningful interpretation by health care consumers. Specialty-specific percentile ranks may help consumers to more meaningfully assess online physician ratings.
Highlights
Health care consumers are increasingly using commercial online consumer ratings websites to rate and select medical providers
Our study showed that overall satisfaction scores are consistently left skewed, fall within narrow ranges, and have different distributions across specialties; as a result, scores that appear high might be in the lowest quartile of scores, effectively misleading patients about perceived quality or experience of care
Overall satisfaction scores fall within narrow ranges; the average interquartile range (IQR) spanned only 1.2 stars for medical specialties and 1.0 for allied health and surgical specialties
Summary
Health care consumers are increasingly using commercial online consumer ratings websites to rate and select medical providers. Even as early as 2012, a survey found that 59% of US adults believed that online ratings websites were “somewhat important” or “very important” in selecting a physician [2]. Payers and health systems are including consumer ratings in their online tools for patients, which provides tacit endorsement for the ratings’ validity in comparing doctors [4,5]. Health care consumers are increasingly using online ratings to select providers, but differences in the distribution of scores across specialties and skew of the data have the potential to mislead consumers about the interpretation of ratings
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