Most Older Patients Choose a Doctor by Convenience, Not Ratings

Jake Remaly

April 20, 2021

The results of a survey indicate that about 20% of older patients say online reviews and ratings are important when selecting a doctor. But other practical matters may take precedence, according to a study published online in Annals of Internal Medicine.

For example, 93% of respondents said it was important or very important whether their insurance was accepted, 61% said travel time to an appointment was important or very important, and 55% reported that office location and hours were.

Online ratings are "but one piece of information that many patients are using when choosing a physician," study author Jeffrey T. Kullgren, MD, MPH, told Medscape Medical News.

Many older adults rated other factors as very important in their decision, he noted. Overall, online ratings were ranked ninth among the factors considered.

Nonetheless, physicians should be aware of online reviews and ratings, because "so many patients are using and value" them, said Kullgren, a primary care physician and researcher at Michigan Medicine and at the VA Center for Clinical Management Research, Ann Arbor, Michigan. But physicians should keep this information in perspective.

Gauging Priorities

To examine the use of online physician ratings and reviews among older adults in the United States, Kullgren and colleagues analyzed data from 2256 adults aged 50 to 80 years who participated in a nationally representative survey in May 2019. The survey was conducted through the University of Michigan's National Poll on Healthy Aging.

The investigators asked participants to rate a range of factors as "not important," "somewhat important," or "very important" when selecting a doctor for themselves. The investigators estimated the percentage of older adults in the United States who consider each factor "very important."

Other factors that ranked above online ratings included a doctor's years of experience (42.3% said it was important or very important), recommendations from other physicians (39.7%), word-of-mouth recommendations from family or friends (23.0%), and being able to interact online, such as through email or to schedule appointments (21%).

Overall, about 43% of survey respondents had ever looked up physician ratings or reviews when choosing a doctor. Women, people with higher levels of education, and those with a chronic medical condition were more likely to have accessed physician reviews and ratings.

Take With a Grain of Salt

Online reviews can be a valuable source of information about patients' experiences with a physician and are one lens through which to view the care provided by a physician, but there are caveats, Kullgren noted. For instance, a review "often does not tell you much about the clinical situation and about some of the other important details about the encounter," he said.

In addition, health systems that share physician ratings and independent commercial review websites vary in the details they provide, the number of reviews, and the way that they collect information, Kullgren said.

Ideally, websites with physician ratings and reviews should provide information that is as "comprehensive, valid, and reliable as possible" and should ensure that there are a sufficient number of reviews about a provider, he said. To that end, clinicians likely will need to continue working with policymakers and the people who run some of these websites, said Kullgren.

"Our data show that this information is valued by many patients," he said. "Given that, how do we provide information that is going to be accurate and could be trusted? I think that we are not quite there yet."

Michigan researchers described some of the survey findings in an earlier report, including how often and why older adults posted online ratings or reviews and how they weighed positive and negative ratings when choosing a physician.

The study was supported by AARP and Michigan Medicine. Support was also provided by the Department of Veterans Affairs. Kullgren was a career development awardee at the VA Ann Arbor Healthcare System. In addition, he has consulted for SeeChange Health, HealthMine, and Kaiser Permanente Washington Health Research Institute and has ties to AbilTo, the American Diabetes Association, the Robert Wood Johnson Foundation, the Kansas City Area Life Sciences Institute, and the Luxembourg National Research Fund. Coauthors have disclosed grants from AARP.

Ann Intern Med. Published online April 13, 2021. Abstract

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