Most patients rely on word of mouth when picking a new doctor

In contrast, online physician rating sites based on cost and quality criteria are used by one in 10 patients looking for a new physician.

By Karen Caffarini — Posted Dec. 22, 2008

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A survey released Dec. 4 by the Center for Studying Health System Change had findings similar to those of a Harris Interactive Poll released in June: A vast majority of Americans prefer word of mouth when choosing a new doctor or hospital, despite a drive to post doctor cost and quality information online.

The survey found 10.8% of patients look to online ratings sites to find a primary care physician, while 50.3% rely on friends or relatives, 38.1% on doctors or other health care personnel, and 34.7% on health plans.

For specialists, 6.8% of patients use online ratings sites, 68.5% seek referrals from their primary care physician, 19.9% rely on friends, 18% on another doctor and 10.5% on health plans. The Harris poll found 22% of patients looked at physician rating sites in 2007, and only 2% changed doctors as a result of what they found on a ratings site.

"The reality is most people have long relied on word of mouth to choose their physicians, and that is still the case," center spokeswoman Alwyn Cassil said.

Maribeth Shannon, director of the marketing and policy program for the California HealthCare Foundation, a proponent of online physician ratings sites, said information revealed by the center showed one possible reason why so few patients are investigating doctors online -- only a minority were in the market for a new doctor.

The center's Health Tracking Household Survey found that only 11% of patients looked for a new primary physician in 2007, 28% needed a new specialist and 16% underwent a medical procedure at a new facility. The national survey contained information on 13,500 adults and had a 43% response rate.

"This study was able to dig down a little deeper. We found the number of people engaging a new physician was low so there was no need for them to go to online rating sites. It was comforting," said Shannon. The foundation commissioned the Harris poll and funded the center's study.

Shannon said the foundation was interested in the center's study after being "very disappointed" by the findings of the Harris poll.

"We wondered, what is the future of online physician rating Web sites?" Shannon said.

Cassil said part of the problem is how the sites determine quality. "Whether we have gotten to the stage where measures used to quantify the quality of a physician's performance is useful to consumers is questionable. Consumers often have different ideas of what a quality physician is," she said.

Shannon believes the number of people utilizing the sites will continue to grow, but at a "slow and gradual" rate. She hopes more people are becoming aware that the sites exist, adding that they tend to draw a younger audience.

"A lot of sites focus on preventive medicine, and people don't get too excited about that versus the outcome of a chemotherapy treatment," she said.

The American Medical Association has monitored the practice of online physician ratings and has opposed it in some cases. The AMA has recommended that online opinions and rankings of physicians not be a patient's sole source for choosing a doctor.

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Selection process

A survey released by the Center for Studying Health System Change showed consumers are a long way from relying on physician rating sites as a means to make health care choices. "Internet" includes any online research, not just cost or quality rating sites.

How patients select a primary care physician
Friends or relatives 50.3%
Doctor or other health professional 38.1%
Health plan 34.7%
Internet 10.8%
Books, magazines, newspapers 6.8%
TV or radio 2.2%
How patients choose a specialist
Referral from primary care physician 68.5%
Friends or relatives 19.9%
Another doctor or health professional 18.0%
Health plan 10.5%
Internet 6.8%
Books, magazines, newspapers 3.6%
TV or radio 1.2%
How patients choose a facility
Doctor performing the procedure 73.9%
Another doctor 14.5%
Friends or relatives 10.0%
Health plan 7.0%
Internet 2.5%
Books, magazines, newspapers 1.8%
TV or radio 0.8%

Source: Robert Wood Johnson Foundation, with partial funding from California HealthCare Foundation. Respondents could choose more than one answer.

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