Do doctor ratings actually matter? And other questions when choosing a doctor.

Maybe the most important aspect of choosing a doctor is your first impression of him or her.

A few weeks ago, I answered a question on Quora about how to pick a doctor that was viewed over 3,600 times. Given the obvious interest in the topic, I figured I would expand on my answer and post it here.

Here’s the TL;DR:

1. Pick a doctor who treats a lot of patients that have the same condition(s) that you have.
2. Ask as many questions as you can at your first appointment to figure out if you like the doctor personally and to determine their level of experience. Finally,
3. Trust your gut. Never be afraid to search for another doctor who is a better fit for you, no matter the reason.

Prior to helping found Orderly Health, I spent several years doing research at Cincinnati Children’s. One of the projects I worked on was trying to rate physician quality. To do this, I was evaluating the validity of patient reviews, trying to define what makes a good doctor, and seeking to better understand the challenges of evaluating patient outcomes. For an extended rant on the shortcomings of provider ratings, jump to the bottom of this post.

In my current role at Orderly Health, I have been fortunate enough to evaluate consumer platforms like Amino, BetterDoctor, PokitDok, Healthgrades, and other companies that help people pick and schedule doctors.

When it comes to choosing a doctor, my general advice is as follows:

1. Find a doctor with experience treating your condition. There is no better predictor of outcomes than a doctor’s experience with whatever it is that ails you. One great resource to find this information for a consumer is Amino.com. (disclosure: Amino helps powers Orderly’s data, so when you use Orderly, you are already using Amino.)
2. When you meet your doctor, ask them about their experience treating patients like you (including age, gender, previous medical conditions).
3. Most importantly, go with your instinct on whether you can build a relationship with this person. You have spent a lifetime quickly evaluating people to determine if you can trust them. Like all relationships, your relationship with a doctor starts with trust and your confidence in their ability. If you are selecting a primary care doctor, that person will hopefully be by your side for the next 20+ years (depending on your age). It is worth working to find the right doctor. If it is a specialist who you may only see once or twice to treat a non-chronic condition, you may not need to cultivate a long-term relationship, but you will still want to trust this person to ensure that you have the best experience with what otherwise might not be ideal circumstances (e.g., undergoing surgery, or treatment for an acute condition).

Regardless of the type of doctor you want to see, you should start your process with Orderly Health. It is free to use, and because we work with some of the best names in the industry (including Healthgrades, BetterDoctor, Amino, among others), you can be confident that you are getting the best data on the best doctors. And if you ever have any questions with any part of the process, our team is always available to help.

Having been on both sides of the table with these conversation (I am a patient, too), I understand how frustrating it can be when you don’t feel like you are empowered to make the best decision for yourself or your loved ones. Hopefully with these simple tips you will feel a bit more informed when it comes to making a decision on your doctor.

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Aforementioned rant on provider ratings: There are a host of products out there that try to rank and rate doctors. Some provide a star rating out of 5 while others assign badges to high performers. The goal of these ratings is ostensibly to give patients the ability to seek out better doctors, which then rewards those doctors in the form of greater demand for their services and therefore higher pay.

There are several inherent challenges with rating doctors:

1. Different stakeholders evaluate doctors in different ways: For instance, if I am an insurance company, I might be most concerned with evaluating doctors based on how they utilize resources. Whereas if I am patient, I might be concerned with only outcomes data or even how likely that doctor is to refer me to a specialist. A governing body has still other incentives, and might be most concerned with population level outcomes. In each case, different stakeholders evaluate doctors on different metrics, many of which impose oppositional or contradictory pressures on the doctors. A fully insured patient on a top tier insurance plan, for example, might prefer the best possible treatment regimen without any regard to cost whatsoever and would rate a doctor according to that yardstick. However, an identical patient with the same condition on a high deductible plan with minimum coverage might provide much higher marks to the doctor that gets them well for the lowest possible cost.
2. Quality of Data: Healthcare data can be difficult to access due to regulation. Different types of data such as insurance data and health records are stored in different places and connecting these data sets in meaningful ways is extremely difficult. These data challenges mean many doctor ratings are based on superficial and incomplete information.

Given these challenges, doctor rating products are necessarily limited in their ability to offer objective guidance on which doctors are better than others. This is why I recommend evaluating a doctor based on their experience and your personal interactions. There is value in using provider rating services, but they offer an incomplete picture. If you use a doctor rating service, consider more than just the rating rather than focusing solely on the 5-star physician. And if you find yourself on Yelp or another review site, keep in mind that these reviews are biased towards those that have bad experiences and providers that actively manage their online reputation.