Physician rating websites: What Aspects are important to identify a good doctor,and are patients capable of assessing them? A mixed-methods approach including physicians' and health care consumers' perspectives

Background: physician rating websites (prws) offer health care consumers the opportunity to evaluate their doctor anonymously. however,physicians' professional training and experience create a vast knowledge gap in medical matters between physicians and patients. this raises ethical concerns about the relevance and significance of health care consumers' evaluation of physicians' performance. objective: to identify the aspects physician rating websites should offer for evaluation,this study investigated the aspects of physicians and their practice relevant for identifying a good doctor,and whether health care consumers are capable of evaluating these aspects. methods: in a first step,a delphi study with physicians from 4 specializations was conducted,testing various indicators to identify a good physician. these indicators were theoretically derived from donabedian,who classifies quality in health care into pillars of structure,process,and outcome. in a second step,a cross-sectional survey with health care consumers in switzerland (n=211) was launched based on the indicators developed in the delphi study. participants were asked to rate the importance of these indicators to identify a good physician and whether they would feel capable to evaluate those aspects after the first visit to a physician. all indicators were ordered into a 4×4 grid based on evaluation and importance,as judged by the physicians and health care consumers. agreement between the physicians and health care consumers was calculated applying holsti's method. results: in the majority of aspects,physicians and health care consumers agreed on what facets of care were important and not important to identify a good physician and whether patients were able to evaluate them,yielding a level of agreement of 74.3%. the two parties agreed that the infrastructure,staff,organization,and interpersonal skills are both important for a good physician and can be evaluated by health care consumers. technical skills of a doctor and outcomes of care were also judged to be very important,but both parties agreed that they would not be evaluable by health care consumers. conclusions: health care consumers in switzerland show a high appraisal of the importance of physician-approved criteria for assessing health care performance and a moderate self-perception of how capable they are of assessing the quality and performance of a physician. this study supports that health care consumers are differentiating between aspects they perceive they would be able to evaluate after a visit to a physician (such as attributes of structure and the interpersonal skills of a doctor),and others that lay beyond their ability to make an accurate judgment about (such as technical skills of a physician and outcome of care). © 2017 adrian aguilera,emma bruehlman-senecal,orianna demasi,patricia avila.