The Hazard of Patient Satisfaction Reviews

The customer is always right—with some exceptions. A prime example is healthcare. Patients turn to healthcare providers to deliver knowledgeable and competent care. As patients, we trust physicians to make recommendations that are in our best interests. However, at a time when companies are increasingly measured by customer reviews, the move to share patient reviews and physician ratings could inadvertently undermine health outcomes.     

There is a growing initiative among hospitals and health systems to publicly display the results of patient surveys and reviews of individual physicians. Websites like RateMDs and Zocdoc also offer physician ratings and reviews. While the concepts behind the reviews—transparency and crowdsourced knowledge—are important in healthcare, organizations should think carefully about the consequences of holding physicians responsible for positive patient/customer satisfaction scores. Here are several key factors to consider:

Many patients demand to be tested
Self-diagnosis and family pressure often drive patients to demand that they be tested or receive some form of medication, even when it’s not necessary. As a result, physicians are pressured to find “something” and treat it. Holding a patient review score over the physician’s head only exacerbates the situation, leading to unnecessary tests and procedures which increase risk as well as additional costs.

Penalizing physicians for unpleasant discussions 
No one wants to be told that they have a serious health issue. Still, it’s up to physicians to deliver unpleasant news. While a patient can seek a second opinion, some may also strike back with a negative review. The result is similar to the first point: The physician will only tell you what you want to hear and avoid difficult conversations.
 
Pay for performance versus satisfaction is a slippery slope
Physicians are responsible for making recommendations that meet a patient’s health needs. However, aligning a doctor’s bonus or income with patient satisfaction incentivizes them to do what the patient wants rather than what is right. Although patient satisfaction is important, it should not be the prime factor in determining treatment.

Customer reviews are skewed
Research has shown that customer reviews are unreliable for a complete view of the customer experience. The average responder is either highly satisfied or highly unsatisfied with the services he or she receives. Furthermore, patients can only rate what they’ve observed, such as a doctor’s bedside manner or the amount of time spent in the waiting room. Relying on patient reviews to select a doctor without considering other factors like experience is risky at best. 
 
Efforts to hold businesses responsible for the services they deliver are valuable, but basing decisions—particularly healthcare decisions—solely on customer satisfaction reviews or scores is a recipe for disaster. Regardless of the industry, business owners should also weigh the value of pressuring employees to strive for glowing customer reviews. Truly customer-centric companies understand there’s a difference in doing what’s best for the customer versus simply giving customers what they think they want.
 
So take reviews with a grain of salt, and if you use them, make sure patients understand the tools’ role in the larger healthcare ecosystem, and the context with which they should be considered.