Physician Ratings A Double Edged Sword Creates the New Normal

UH Clinical Update - July 2016

By Cliff Megerian, MD, President, University Hospitals Physician Services

This is the time of year when the attention of health care providers is drawn to rankings -- most notably those issued by U.S. News & World Report. University Hospitals and its institutes and service lines consistently fare well in these assessments.

However, in addition to hospitals being rated, physicians are now being rated individually. Soon, nearly every physician’s ratings and reviews will pop up online as soon as someone searches for that physician’s name. In many cases, this is already happening.

This is a double-edged sword. Yes, patients can easily find you and read about your credentials and affiliations. On the other hand, some of these assessments are based largely on opinions and experiences that you may feel are not under your control or that have little to do with the actual delivery of care. You find yourself, having studied, trained and practiced for perhaps a decade or more, reduced to assessments with tremendous subjectivity.

For example, the patient ratings score of a doctor who treats patients with diabetes doesn’t reflect how well he or she manages glucose levels, regulates insulin or follows A1C levels. Online rating sites such as Vitals, HealthGrades, Angie’s List or Yelp don’t offer ratings based on surgical cure rates or post-op infection rates. Rather, many of the online reviews often are subjective reports by patients about issues like a receptionist’s perceived friendliness, or non-medical issues such as office environment or wait time. These ratings reflect the general impression the patient had when he or she left the office, regardless of whether the physician provided outstanding care. Based on these realities, it has become quite clear now that when asked to report on a doctor visit and rate a physician, patient perception is as significant as the quality of care provided – in the mind of the patient.

A UH Alternative

But this is the “new normal.” As physicians, we have to accept this level of transparency. Here at UH, we’re not passively waiting while third-party, for-profit companies (who may not even have accurate information about us) control our online reputations. Instead, we’ve created a rating and review system of our own with the medical consulting firm of Press-Ganey. This system is in line with CMS indicators. We’re also collecting our own data, rather than letting third parties populate it online. In addition, we’re creating our own five-star rating system designed to supplant subjective, for-profit sites, which often don’t include measurements most relevant to patient experience. Results from this new rating system will rank higher when a patient does a Google or other online search.

Managing Reputation

As a system, we’re also stepping up to help our physicians. We’re now measuring every visit and discharge associated with one of our UH physician offices, hospitals, urgent care centers and emergency rooms. Measuring how a patient feels is crucial to how well we do on patient engagement scores. And we’re emphasizing, throughout our system, that our goal is to deliver care in a way that patients review results accurately, and that these results reflect high-touch care that each of us will be proud of.

Simply put, we are not going to abdicate our professional reputations to outsiders who don’t care if the information they provide is accurate.

Even as I say that, I also want to note that as providers, we must realize that the way the patient feels about the totality of the visit to his or her physician is extremely meaningful. It has a profound effect on trust. Please work with your office staff, physician assistants, medical assistants, advanced practitioners and nurses to understand and respond to patient perceptions and to create a culture of exceptional service in your daily work environment. The physician often sets the tone and culture of his or her workplace setting.

We’ll soon complete the creation of our own five-star rating and review system. Joan Zoltanski, MD, MBA, our Chief Patient Experience Officer, is working on this with the input of a patient quality-satisfaction advisory committee. Please contact her at Joan.Zoltanski@UHhospitals.org if you are interested in helping create this system. It’s one that will likely have a huge impact on how UH physicians are rated in the months and years to come.