Author: Adrienne Boissy, MD, MA
Imagine you need to buy a new washing machine. How do you start? If you’re anything like me, you go straight to the Internet and look up the customer reviews. Most big retailers post aggregate customer ratings of one to five stars to help you make the best choice. Online comparison shopping has revolutionized commerce and given consumers unprecedented power of choice.
Now something similar is coming to healthcare. Cleveland Clinic recently began posting patient ratings of individual doctors on its website, along with comments from patient surveys. Online doctor ratings range from one to five stars, and the comments are altered only for obscenity, irrelevance or potential libel. It’s controversial — especially among doctors. But we believe it’s a necessary step to improve transparency and accountability in healthcare.
Breaking Down the Online Doctor Ratings
What do the online doctor ratings look like? Let’s look at my physician profile on Cleveland Clinic’s website (pictured below). It includes comprehensive professional information, a brief biography, and industry relationships. Right below my picture is the patient rating – five stars, based on 35 patient satisfaction surveys. There is a link to patient comments — three as of this writing. All of them pretty good.
Patients do not directly enter their online doctor ratings and comments, as they would on Amazon or other retail sites. The ratings and comments are those of patients who have been randomly invited to take a detailed patient survey after their Cleveland Clinic visit. About 190,000 patients a year accept the invitation. The survey and its results are administered by an independent company to assure objectivity.
Six factors are considered
To arrive at the star ratings, patients are asked to give their doctor a score of one to five, based on whether the doctor:
• Listened carefully to the patient
• Knew the patient’s medical history
• Explained things clearly
• Gave clear and concise instructions
• Spent enough time with the patient
• Respected patient’s needs and concerns
The six factors are averaged to generate a one to five-star rating. Patients who take the survey are also invited to offer their written comments. The written comments go up on the website — whether they are positive, negative or indifferent. The commentators’ names are omitted, along with any information that might compromise patient confidentiality.
Designed for Big Data
The doctor rating system only went online in April, 2015. It’s still a work in progress.
Big data works best when there are a great many data points. Most doctor rating sites are useless because they are based on only a handful of unverified patient inputs.
Cleveland Clinic will not post a rating until the doctor has accumulated at least 30 survey responses from actual patients. With more and more surveys coming in every day, our doctor ratings will eventually reflect hundreds of thousands of patient responses, with old responses continually dropping off and new ones coming on.
Transparency is risky. Not all doctors are happy about it. But online ratings are causing us all to focus even more intently on patient satisfaction. Cleveland Clinic is the first major academic medical center to take the online ratings plunge. You can be sure that many others will follow.
About the Author
Adrienne Boissy, MD, MA, is Chief Experience Officer of Cleveland Clinic Health System, and a staff physician at the Cleveland Clinic Mellen Center for Multiple Sclerosis with a secondary appointment in the Center for Ethics, Humanities and Spiritual Care.