Online ratings and feedback have become a driving force in business. Our eyes go straight to the star ratings when we make an online purchase. A majority of consumers read reviews and choose where to spend their money based on other consumers' experience. For healthcare, 70% of people say reviews are crucial to selecting a provider. Reviews can reflect facilities as well as individual providers across general consumer sites such as Google & Yelp and healthcare-focused review sites such as Vitals and Healthgrades. In a way, it has become an informal reputation record determined by patients. What are some of the pros and cons of online feedback?

When consumers buy a manufactured product, they expect its performance to match what is claimed by the manufacturer. Services, such as a restaurant or hotel, can be more complex with the addition of human interaction. Healthcare has the additional factors of the patient's health concern, often attaching at least some risk for the patient and a high level of emotion depending on their perception of care received. So what is the difference between reviewing a lawnmower, local diner, and major hospital? Nothing according to Google. It displays ratings and reviews in search results that do not take into account the difference. But it is going to be the first impression many people have unless they take the extra step of going to healthcare rating sites focused more on individual physicians.

The real problem lies in the gap between reality and expectations. Most patients are informed by what they see in the media: idealized hospital commercials, heroic Hollywood renderings, dark newscast worst-case-scenarios, and ambulance-chasing malpractice attorney commercials (not all attorneys are bad - we certainly need legal protections, but usually what is depicted on TV is more dollar than justice-oriented). As a result, a majority of patients and family members don't have a realistic expectation. Combined with the currently limited amount of time for interaction with providers and the difficulty of relaying complex medical ideas and statistical likelihoods, a patient's perception of what a positive outcome is, how likely it is, and the risks involved are not properly set. Additionally, thanks to "Dr. Google", the patient may have an idea of what treatment or medication they should receive. In addition to that, the patient may disregard their own role in treatment and recovery. So how does a patient come to the perception that they have been wronged and provide a bad review? All of those factors play a part. There are many ways a patient can have issues of trust and confidence that could lead them to write a bad review.

On the other hand, online reviews give patients an unrestricted platform to share their experience. People trust reviews; in one survey, 84% of respondents trusted reviews as much as a friend. A descriptive review can provide other patients with a first-person perspective on the best provider to replace a hip or to watch out for a rude receptionist. But future patients are not the only ones who can benefit. Reviews can be an important source of information for the provider or practice. They can learn where patients see excellence or a need for improvement. Reviews are also a good source of market information. Are your competitor's wait times out of control?...or are people raving about a new procedure they are trying? Reviews can be an insight into what patients' expectations are for a clinical visit. If expectation doesn't meet reality, it is an opportunity to make improvements.

Good or bad, reviews are here to stay. So how do you deal with them? Panic? Ignore them? Request them? Reply to them? We will look into some best practices for online reviews in an upcoming post.