HARRINGTON: In defense of doctor reviews

Online doctor reviews will improve patient healthcare

Recently, my fellow columnist Alex Yahanda argued against the value of online physician reviews for patients looking to choose a doctor, a practice that a University of Michigan study found to be on the rise. He explained that since the average patient is under-informed about medicine, reviews value a physician’s charisma over his talent as a clinician. Furthermore, he claimed medical care is too important to be influenced by anonymous strangers’ opinions. He concluded by calling for everyone to treat such reviews skeptically and instead to choose doctors from recommendations of their family, friends and other physicians.

However, Yahanda overlooked the enormous potential in such review sites. Anonymous reviews can be useful to patients. They can offer more information on the patient perspective than another physician could and can cover a wider range of specialties and geographical areas than one’s personal network could. While Yahanda expressed concern that people are too trusting because they are accustomed to using anonymous reviews when shopping online, I believe this habit has honed their skills at dissecting reviews. Patients web-savvy enough to look at physician reviews online are capable of blocking out obviously hyperbolic rants, ignoring attempts to critique a physician’s medical skill and concentrating instead on the details of the patient experience. I believe this emphasis on a physician’s patient treatment is important and can indeed “help individuals make better healthcare decisions.”

Reading about others’ experiences with a doctor could be a particularly effective tool for patients who are deciding whether to visit any physician at all. Research has shown that fear of healthcare professionals’ biases causes many people who are LGBT, obese or HIV positive to delay or avoid seeking treatment for medical issues. Reading about a physician’s overall compassion or his consciousness of the needs of groups facing discrimination could lead someone to make an appointment despite prior negative experiences with medical professionals. Although Yahanda believes each different patient cannot assume he will have the same experience, a respectful doctor will treat anyone with dignity. Here his commitment to patient-centered care would prove more important than his clinical skills, as it would have led someone to seek medical care which would have otherwise been avoided.

Patients’ use of reviews can also improve a physician’s ability to treat them. By basing their choice of physician on reading others’ experiences, patients can enter an appointment with the expectation of an attentive doctor and a pre-existing investment in the doctor-patient relationship. This is not unlike how roommates who choose one another on Facebook feel a responsibility to make the relationship work. Therefore, patients would more easily develop the trust in their physician that enables disclosure of sensitive information and compliance with the treatment plan.

The fictional Dr. House from the popular medical show “House, MD” may be an acclaimed diagnostician, but patients’ distrust of him hinders his ability to diagnose. In one episode, an elderly nun does not tell the doctor she has a copper IUD, leading to a life-threatening allergic reaction and unnecessarily wasting House’s time on contemplating other potential explanations of her symptoms. Quickly earning his patient’s trust, rather than being dismissive, might have allowed him to use his medical skills more prudently.

What is most exciting about online physician reviews, though, is their ability to allow conscientious doctors to use their own reviews as a free focus group to reveal where their patient-centeredness needs improvement. Reviews can reveal problems with a physician’s bedside manner that are simple to correct, such as his failure to fully explain treatment options or maintain eye contact when listening. By responding to these concerns, a physician who is not instinctively good with people or was never instructed on bedside manner can reap the benefits of an improved patient-doctor relationship, both in his patients’ health and his practice’s economic viability.

Today many of these benefits of physician reviews have not yet been realized, as reviews are concentrated around major cities, focus on specialties patients fear like gynecology and are fractured among different websites. However, I believe this situation is temporary, as physicians have become less resistant to reviews in just the past few years, with some even encouraging patients to review them. I am optimistic about the potential of this new resource for patients. When Yahanda’s and my generation moves to a new city for its first post-collegiate job and needs to choose a new doctor, I hope many individuals will look to online reviews to see a snapshot of patients’ experiences. I know I will.

Elaine Harrington is a Viewpoint writer.

Published March 5, 2014 in Opinion

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