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    Physician review websites: The good, the bad, and the technology


    Objectifying the subjective

    Hospitals and soon the government will be sourcing Internet-derived patient-reported data. The Hospital Consumer Assessment of Healthcare Providers and Systems Survey (HCAHPS, pronounced “H-Caps”) is a standardized survey and data-collection tool designed to measure patient opinions of hospital care in 11 categories.10 Through use of natural language processing technology to analyze Yelp reviews of hospitals, a recent study identified 12 additional categories that are not currently covered by the HCAHPS survey: cost of hospital visit, insurance and billing, ancillary testing, facilities, amenities, scheduling, compassion of staff, family member care, quality of nursing, quality of staff, quality of technical aspects of care, and specific type of medical care.11 This study, the first of its kind, elegantly demonstrates how technology can be harnessed to turn highly subjective reviews into actionable data.

    However, all review websites are subjective and subject to the quality of the information provided by the patient/consumer/reviewer, ultimately leaving the "online reputation" of the physician in the hands of reviewers and anonymous (and hard to reach) website administrators. In a refreshing twist on how a physician review website should look, feel, and behave, Jake and Deb Anderson-Bialis created FertilityIQ, an objective site of subjective reviews.

    On the surface, FertilityIQ appears to be just a niche fertility-focused physician review website. However, the site is focused on obtaining the facts about the patient-provider experience and turning the subjective into objective. Patients are asked to do more than just click stars: They can add their own fertility history; share their experiences and outcomes with doctors, nurses, and clinics that treated them; and skip any answer they want. And while the first part is already enough to set FertilityIQ apart from generic physician review websites, the fact that reviewers’ authenticity is confirmed, is truly incredible. According to the website, "after you complete an assessment, you email us something to show that you were a patient at the clinic you rated. We ask that the clinic name and your name be legible, and no sensitive information is required. This can be a forwarded e-mail message from someone at the clinic, a partial bill, a screenshot of a patient portal, or anything that shows you were a patient. Once we receive your document, your assessment will be marked as ‘verified’ on FertilityIQ.”12 The patient/reviewer-derived data are compiled to show how likely patients are, on a scale of 0 to 10, to recommend a doctor to a friend, in addition to metrics of quality of communication, degree of individual attention, and responsiveness.

    Patients' and providers' interests are aligned; we all want more and better data. Consumer-level sites such as Yelp and Google weren't designed to review medicine and as such, these reviews should not drive patient decisions about who to see, and should not lead physicians to make false assumptions about the quality of their care. Furthermore, while websites such as HealthGrades, Vitals, UCompareHealthcare, and RateMDs are designed for healthcare, the lack of oversight combined with the power of a vocal minority of reviews can misinform patients and providers and lead to dangerous outcomes. FertilityIQ is just the first of what likely will be many websites that are introducing multi-dimensional reviews with requisite patient verification. Sites such as these have great potential utility when applying for hospital privileges, negotiating insurance contracts, or simply considering hiring a physician.


    Brian A. Levine, MD, MS, FACOG
    Dr. Levine is Practice Director at the Colorado Center for Reproductive Medicine, New York, New York.


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