Yelp'ing Your Doctor -- How Accurate Is This?

A few decades ago, when your parents or grandparents used to look for a good restaurant for dinner, they’d go to the barbershop, grocery store, or bank where they’d run into their friends and get personalized recommendations.  Restaurants that excelled in customer service, cleanliness, and of course, decadent food inevitably stood out from the rest – and a friend’s review of a restaurant was thought to be the most accurate reflection of that restaurant.  However, as many of us have experienced, a restaurant can oftentimes breed very polarizing opinions.  This can be due to not only slight differences in the service, cleanliness, or quality of the food between customers but also can be affected by each individual’s variable preferences.  A restaurant that normally provides excellent customer service may have a day where some of the staff have called out sick and the ones left to pick up the extra workload become stressed and eventually frustrated – which eventually is noticed by restaurant patrons.  A customer may have asked for a meal without cheese, and because of a slight mix-up in the kitchen, the special request doesn’t get relayed – a mistake that oftentimes costs the business a sub-par review.

All in all, the restaurant industry is a tough one for all of the above reasons.  But one thing is for certain – new restaurants live or die based on person-to-person recommendations.  They thrive when word spreads about their excellent food and customer service, and they shut down if they don’t satisfy the majority from the get-go.

In the past decade, online reviews of the restaurant industry have led to a common forum for personal restaurant recommendations to be shared via the internet.  You can now stop depending on just your friends and can instead read what thousands of people you’ve never met are saying about the restaurants around your neighborhood.  This has led to companies like Yelp being able to thrive on standardizing the review process by providing an application (for your phone or computer) to browse through restaurants that may interest you based on your preferences.  However, these reviews are subject to the same variabilities that existed previously – i.e. Will I like the same things that these other people like, or did they have a bad experience just because of something out-of-the-ordinary that was going on that day?  Also, who are the people posting reviews of restaurants?  Do they only tend to post something if something really bad or really good happened, making these scenarios the rare experiences in that restaurant and not the average experience that the restaurant has to offer?

As of now, there is no good forum for online physician reviews.  One reason for this is because the patient-physician relationship has always been deemed to be very private and confidential.  Revealing that you are seeing a certain physician can sometimes give away that you have certain diseases that you may not want to share with your friends or family.  But as our generation becomes more comfortable with the transparencies that social media and the internet have created, online physician reviews are starting to become more popular.  But a doctor’s office has noticeable differences compared to the restaurant industry, and these differences may govern the nature of reviews that you might see currently on Yelp or other websites.

Customer service makes up only a portion of the experience at your doctor’s office.  A physician’s goals are not to serve you an “appealing” diagnosis and sugar-coat it so that you are able to digest it and be happier walking out of his door than when you walked in.  A good physician will, instead, take bad news and help a patient understand the real-world implications of the disease and the next steps to be taken.  Oftentimes, the diagnosis is tough to understand, so the real beauty of the patient-physician relationship is realized when the patient truly understands his own condition and how to live with it and temper its effects on his body in order to live out a truly meaningful life despite the diagnosis.

Have you ever told a friend something he or she didn’t want to hear? Even if it was good for them to hear it? That’s what it’s like to be a doctor – every day!  Almost every conversation is at risk for being potentially friendship-ending.  Additionally, different doctors have different tactics, and some are more paternalistic than others in the way they treat their patients.  So it might be the case that one patient likes a certain physician’s style and not another’s.  There’s no way of knowing this until you go in for your first visit and see for yourself.  But it’s easy to see how one doctor can have scathing reviews while others are glowing.

Times are changing in medicine, and with easy-to-access online medical information, more patients are coming to the doctor’s office equipped with their own strong personal opinions of their disease and treatment plan.  Physicians are constantly balancing their patient’s strong opinions with the traditional medical teaching and guideline-based therapies.  Any differences of opinion in these situations can sometimes lead to heated disagreements between patients and physicians.  Physicians have differing thresholds for how much they will “give in” under these circumstances, and it can have significant implications on their public reviews and referrals.

Lastly, with the small numbers of reviews that most physicians have on these online review websites, one has to wonder about why people are posting a physician review and whether there is a selection bias for those that take the time to speak out.  Could it be that only the disappointed patients are being vocal, while the ones who continue to be served by that physician prefer to remain quiet and anonymously connected to the physician?  The sheer number of reviews for popular restaurants on Yelp would hopefully allow for the extremes of judgment to fall by the wayside and, thus, permit the consensus opinion to shine through.  Physician reviews aren’t there yet simply because of the lack of usership.

So the next time you “Yelp” a doctor, take a minute and think about why those patients are posting that review.  And remember that you may have a different experience at that physician’s office depending on the type of person you are – which can be for the worse OR better!

Doc Veritas

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