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 Researchers examined data on 665 urologists with Medicare patients
in California, looking at how many patients they treated as well as
what types of reviews they got on four websites: Yelp.com,
Vitals.com, Healthgrades.com and Ratemd.com.
Half of the urologists treated at least 426 patients covered by
Medicare in 2014. Overall, the physicians who treated fewer patients
got higher satisfaction ratings online, the study found.
"There could be more than one explanation for this but our
hypothesis is that patients are happier when there is less waiting
and more time to communicate with the doctor," said lead study
author Dr. Gregory Murphy, a researcher at Washington University
School of Medicine in St. Louis, Missouri.
"I think it shows that patients value efficiency, ease of access and
communication," Murphy said by email.
Although the accuracy, usefulness and meaning of online reviews is
debated by doctors, they increasingly influence decisions about
where patients choose to receive care and impact how hospitals and
health systems evaluate doctors' performance, the study team writes
in JAMA Surgery, online March 21.
Online reviews may be influenced by a variety of factors that go
beyond the quality of care to include things like waiting times to
see physicians, the ease of scheduling appointments and how long
doctors spend in exam rooms, the authors note.
For the study, the researchers examined physician billing and
reimbursement data as well as the number of Medicare patients they
saw and how many services they billed for in 2014.
Most of the urologists in the study were male, and they
predominantly worked in nonacademic settings.
On a scale that ranged from a low of 1 to a high of 5, academic
doctors on average scored a 4.2 rating on the various patient
satisfaction websites in the study. Outside of academic settings,
doctors scored an average rating of 3.7.
Female urologists got similar satisfaction ratings as males, the
study also found.
For every 100 patients seen, average patient satisfaction ratings
dropped by 0.04 points.
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Limitations of the study include the use of Medicare data from
propublica.com, which may not accurately represent a physician's
non-Medicare patient population, the authors note.
The study also wasn't a controlled experiment designed to prove
whether or how the number of patients doctors treat might influence
satisfaction ratings on consumer websites.
Even so, the results suggest that doctors need to spend some time
talking to their patients, Murphy said by email. When complications
happen during treatment or surgery, patients may feel better about
the experience when they feel like their doctor listens to them.
"Patients want someone who communicates well and listens in those
unfortunate and frightening moments," Murphy said.
It's possible that the results might not fully capture how many
patients doctors treat, however, because it only focused on people
insured by Medicare, the U.S. health program for people 65 and
older, said Dr. Brian Radbill, chief medical officer and vice
president of medical affairs at Mount Sinai St. Luke's in New York
City.
Older patients may have more complex medical needs and require more
time and attention than younger patients, Radbill, who wasn't
involved in the study, said by email.
Specialists, especially in urology where surgery is often involved,
may only interact with patients a few times and have limited
opportunities to build a relationship Radbill added.
"To the patient, it is often a completely alien, frightening
experience so the patient may get the absolute highest quality of
care, but the experience may be perceived as poor," Radbill said.
"They may leave feeling like they were not treated well - perhaps
the doctor swooped in and swooped out, did not engage them like they
are used to."
SOURCE: https://bit.ly/2IQmdeD
JAMA Surg 2018.
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