Anytime Andy Pasternak, a family medicine physician in Reno, Nev., needs a slice of humble pie, he turns to one source.
"Usually if I am feeling good about myself and want to keep myself hungry, I'll Google my reviews," Pasternak says.
Indeed, some of the reviews on Pasternak's Yelp page (bit.ly/silver-sage-yelp) are downright mean: "Limited and narrow-minded way of thinking," "distracted from his job as a primary-care doctor," and he has an attitude that is "dismissive."
Not all of them are bad, and overall, his Silver Sage Center for Family Medicine has more positive ratings than negative ones. He has a three-star rating on Yelp and Vitals, and three-and-a-half stars on HealthGrades. Top-end restaurants in New York have been ranked worse.
For many docs though, the negative reviews stick out. While some may be warranted, physicians feel many come from people with grudges. "I've found them to be a little frustrating because for most of the online review sites, there was no way for me to be sure people writing the reviews had actually seen me in the office," says Ira Nash, an internal medicine physician and senior vice president of the North Shore-LIJ Medical Group, with various locations in New York.
These sentiments are echoed by a number of doctors not exactly enthralled with the idea of their professional expertise being judged on Yelp, HealthGrades, Vitals, or any other website. Yet for better or worse, research shows that online reviews are how they're increasingly being discovered and judged.
A survey of approximately 3,000 patients, from Boston-based health tech company Nuance, discovered that more than half of millennials (the generation of patients in their mid- to late-30s and younger) say they use online reviews to shop for a doctor. Another survey, from Austin-based consulting firm, Software Advice, found that 42 percent of all patients said they used online reviews in 2014, which was up from just 25 percent in 2013. "We're starting to see the shift in online access to individual provider information becoming more real, and more real to individual providers," says Anthony Oliva, the national medical director at Nuance.
Driving this demand is a conglomeration of consumerism and technology, according to experts. Patients expect it, says Nash, as part of a larger culture where all forms of decision making (from going to a restaurant to picking a pair of shoes) can be crowdsourced. Furthermore, consumerism has been integrated into healthcare, as part of the shift from volume to value. While the government isn't using a physician's Yelp score to determine Medicare reimbursement, there are the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) and Clinician & Group Consumer Assessment of Healthcare Providers and Systems (CG-CAHPS) surveys. The HCAHPS is given to patients at discharge and can have an impact on a provider's Medicare total reimbursement, while CG-CAHPS is required as part of the Physician Quality Reporting System.
Moreover, thanks to the Internet and other technological innovations of the last 20 years, patients are more empowered than ever to make healthcare-related decisions. It doesn't just stop at picking a provider. The Nuance survey reflects how younger patients are coming to the doctor's office armed with health information they found online. A survey from the Pew Research Center found that 72 percent of Internet users (87 percent of people surveyed) looked online for health information.