Online referral forum sees jump in health care hits

The popular Angie's List service plans an expansion of its health care ratings tool and will launch a stand-alone health publication for members.

By Emily Berry — Posted Jan. 19, 2009

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Plumbers still beat out doctors in the search frequency on consumer referral Web site Angie's List. But the popularity of the company's recently launched health care segment has prompted its executives to wonder if health care won't soon be a bigger part of its business than the home services referrals that have been the site's staple.

Angie's List started in Columbus, Ohio, in 1995 and now claims 750,000 members in more than 100 markets. The now Indianapolis-based company began allowing members to rate health care businesses, including doctors, dentists, hospitals and health plans, in early 2008.

By January, an estimated 60,000 reviews were entered into the health care section of the site, and members had done more than 3 million searches for health care services, said Mike Rutz, vice president of Angie's List Health. Angie's List plans to upgrade and widen its health care ratings section in February, and it will launch print publications for members in Indianapolis and Columbus that will focus solely on health care, he said.

Rutz said it's "absolutely a possibility" that health care will become the dominant sector that Angie's List members search and review.

"Let me put it this way -- right now as far as our reports are concerned, over 20% are health reports, and of our searches it's over 10%," he said. "This is very young -- not even a year old -- and we haven't even gone to a great effort as far as actively marketing it."

Angie's List is far from alone in its effort to bring the power of word-of-mouth referrals online. Most recently, WellPoint offered its affiliated Zagat physician rating tool to BlueCross BlueShield of North Carolina so its members could rate their doctors. Various surveys show word-of-mouth to be the most popular way for patients to choose a physician.

Angie's List, however, said it is making some effort to reach out to doctors to improve its site. Rutz has spoken on the phone with and met personally with members of the Ohio State Medical Assn. over the past several months to discuss physicians' takes on the ratings.

OSMA President Warren Muth, MD, a general surgeon from Dayton, said the dialogue with Angie's List staff has been "extremely cordial and productive."

OSMA members asked if physicians could see and have a chance to respond to complaints before they are posted, and worked on a way to resolve the privacy issue so physicians would be able to respond online to what's said about them.

The conversations led the site's staff to make some changes with the February expansion, including embedding a HIPAA waiver for members submitting reviews, Rutz said. (See correction)

Without the patient's permission and signed waiver, there was no way for physicians legally to respond to a compliment or complaint (although the site allows them to do so) because of the federal privacy law enacted as part of the Health Insurance Portability and Accountability Act of 1996.

Rutz said the improved site will give members an opportunity to let Angie's List help resolve a dispute with a doctor or other professional; if the problem is resolved, the member is asked to revise his or her review of that doctor.

Angie's List does not allow a member to post a review while in litigation with the professional or company he or she is reviewing, and the person or company being reviewed can always find out the full name of the member entering the review by calling Angie's List.

Still, Dr. Muth said, he and other doctors are wary of Angie's List trying to offer referrals based on clinical measures. "If it's a complaint about waiting times, 'I had to wait x number of hours,' or 'the office is dirty,' 'the people were unfriendly,' those things are maybe legitimate complaints," he said. "Angie's List shouldn't get into the outcomes business."

Rutz said the updated site will show more than just reviews -- it will show links to allow members to check a doctor's board certification and medical education.

Dr. Muth said it's unlikely these types of ratings sites will go away, but he said he hopes they can at least offer doctors a fair shake. "I don't know whether physicians are worried about rating services, but [rather] what we are rating, and can the physician have first right of response?"

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This article should have said that online rating site Angie's List requires members to sign a HIPAA waiver to initiate a dispute resolution process with a physician, but that a waiver is not required for a member to submit a review of a doctor. American Medical News regrets the error.

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