Patient-rating websites top Google searches for best doctors

Despite the proliferation of health care quality and cost information online, for-profit websites that rely on anecdotal patient reports are the easiest ones to find using the Google search engine.

Of the top 30 results that appear when searching for physician-centric terms such as "quality clinic" or "best doctors Minnesota," 67% include information based on patient experience. Only 22% of the results feature data drawn from evidence-based measures of physician performance.

More than 80% of the health rating sites that are "highly findable" -- those that show up repeatedly as top results in response to queries such as "doctor reports" and "hospital ratings" -- draw on anecdotal patient reports. Half of the sites include quality information, and only a third feature cost data, according to an American Journal of Medical Quality study published in November.

"When we look at those sites that are highly findable, they're all private, and most of the information on those sites is patient experience and not cost or quality information," said Brian Sick, MD, medical director of the University of Minnesota Primary Care Center. "This is a person putting up data about their anecdotal experience with a particular physician or clinic. That's certainly of value to some people, but it is going to be skewed."

RateMDs.com, Vitals.com and Yelp.com were among the "high findability" health content providers. All of the relevant top-30 results for physician-centric search queries yielded sites that included rating information taken from patients. Only 44% of these sites also featured performance results based on claims data or board-certification information.

Desperately seeking quality

"The sites that have the information that we would prefer patients to look at because it's good and comparable across various clinics, hospitals and physicians -- those are not the sites they are going to find easily," said Dr. Sick, assistant professor of medicine at University of Minnesota Medical School. "So they don't find the information we'd find relevant."

For example, a website run by the nonprofit MN Community Measurement collects information from claims, medical records and patient surveys to rate clinics and medical groups on the care they deliver for patients with conditions such as depression, vascular disease and hypertension. About 90% of primary care sites in Minnesota report to the group, whose site also features cost information. Yet the site did not show up in any of the searches for hospitals or clinics in Minnesota, the study found.

"We need to do a better job of steering patients toward the right place and playing the game a little bit with Google," Dr. Sick said. "It is important that when we talk about this with our patients that we say that quality care is not just whether you liked your doctor. ... It should be about going online and seeing who really takes good care of diabetics because you have diabetes and you're worried about your future."

The data may paint a bleak picture of how difficult it is for patients to find meaningful health quality information online, but physicians may take some solace from the fact that few patients appear to make use of Web resources when choosing a doctor. Only 9% of nearly 500 patients surveyed at four Minneapolis clinics said website information influenced their physician choice, according to a study Dr. Sick co-wrote in the March/April Journal of Healthcare Management.