Doctors hate ratings—oh, wait!

When journalists get nasty letters, we tell ourselves that readers are more likely to offer feedback when they have something negative rather than positive to say. With online ratings of doctors, however, it may be the opposite.

If physicians at the American Medical Association are any indication, doctors approached the idea of being rated by patients with dread and anxiety. This is reflected in AMA policy D-478.980, which consists of four provisions, with the third being: "seek legislation that supports the creation of laws to better protect physicians from cyber-libel, cyber-slander, cyber-bullying and the dissemination of Internet misinformation and provides for civil remedies and criminal sanctions for the violation of such laws."

Yet, according to a new report, most patients who submit online ratings are saying nice things about their doctors.

The report, "A Changing Landscape of Physician Quality Reporting: Analysis of Patient Online Ratings of Their Physicians Over a 5-Year Period," was published in the Journal of Medical Internet Research. It analyzes data from 386,000 ratings from 2005 to 2010 from, one of the oldest physician-rating websites.

It's estimated that one in six doctors was rated, and the average individual score for physicians was 3.9 on a one-to-five scale, with ratings based on helpfulness and knowledge. (Ratings for physician offices as a whole also included ratings on staff and punctuality.) The authors—from Harvard University and the universities of Maryland and Minnesota—wrote about how unexpected the results were.

"Critics worry that the Internet rating sites will be a forum for disgruntled patients to vent frustration over minor shortcomings, and that a small number of such ratings might tarnish physicians' reputation," the authors wrote. "Professional societies such as the American Medical Association and even some state governments have expressed concerns about these rating programs. Since most rating websites do not require the authentication of raters, online ratings may be subject to manipulation."

The numbers are somewhat skewed and show that, as of January 2010, the average number of ratings per physician was 3.2, but nearly half of those reviewed had only one rating. Other findings included that obstetricians/gynecologists were the most likely to be rated, with about 32.43% receiving a rating, compared with 24.6% of medical specialists, 20% of surgeons, 16.3% of primary-care doctors and only 6.6% of "other specialists" such as radiologists, pathologists and anesthesiologists.

Primary-care doctors had the highest average score, 4.0. The average male physician scored above the average female doctor, 3.95 vs. 3.89. While the authors note that patients were more critical of staff and punctuality, nearly half of the physicians rated received a perfect five rating and only 12% had ratings below a two.

"Online ratings appear to be driven by patients who are delighted with their physicians," the researchers concluded.

Follow Andis Robeznieks on Twitter: @MHARobeznieks.



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