Abstract
BackgroundPhysician rating websites (PRWs) are a device people use actively and passively, although their objective capabilities are insufficient when it comes to judging the medical performance and qualification of physicians. PRWs are an innovation born of the potential of the Internet and boosted very much by the longstanding policy of improving and encouraging patient participation in medical decision-making. A mismatch is feared between patient motivations to participate and their capabilities of doing so well. Awareness of such a mismatch might contribute to some skepticism of patient-written physician reviews on PRWs.ObjectiveWe intend to test whether health literacy is able to dampen the effects that a patient-written review of a physician’s performance might have on physician choice.MethodsAn experiment was conducted within a survey interview. Participants were put into a fictitious decision situation in which they had to choose between two physicians on the basis of their profiles on a PRW. One of the physician profiles contained the experimental stimulus in the form of a friendly and a critical written review. The dependent variable was physician choice. An attitude differential, trust differential, and two measures of health literacy, the newest vital sign as an example of a performance-based measure and eHealth Literacy Scale as an example of a perception-based measure, were tested for roles as intermediary variables. Analysis traced the influence of the review tendency on the dependent variables and a possible moderating effect of health literacy on these influences.ResultsReviews of a physician’s competence and medical skill affected participant choice of a physician. High health literacy dampened these effects only in the case of the perception-based measure and only for the negative review. Correspondingly, the effect of the review tendency appeared to be stronger for the positive review. Attitudes and trust only affected physician choice when included as covariants, considerably increasing the variance explained by regression models.ConclusionsFindings sustain physician worries that even one negative PRW review can affect patient choice and damage doctors’ reputations. Hopes that health literacy might raise awareness of the poor basis of physician reviews and ratings given by patients have some foundation.
Highlights
Physician Rating Websites Physician rating websites on the internet (PRWs) came about as a synergy between technological innovation and social reform
Participants were put into a fictitious decision situation in which they had to choose between two physicians on the basis of their profiles on a PRW
EWOM devices soon reached into the field of health care, with PRWs as a prominent example
Summary
Physician Rating Websites Physician rating websites on the internet (PRWs) came about as a synergy between technological innovation and social reform. PRWs are promoted as a medium to increase transparency by communicating health care consumer experiences physicians to a large audience These websites are becoming increasingly popular; as many as 59% of participants in a representative American study indicated that PRWs were important when choosing a doctor [6], while 25% of Germans [7] have searched for a doctor on the internet. The simple, comprehensible, narrative nature of physician rating websites seems to catch users’ attention and appeal to them more than formal quality information such as academic qualifications, degrees, or areas of specialization [9] Awareness of such a mismatch might contribute to some skepticism of patient-written physician reviews on PRWs
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