Quality Guide

The problem with Healthgrades, Vitals, Yelp and other Internet complaint boards

Philosophically, Varsity Orthopedics believes strongly that the best healthcare comes from an educated healthcare consumer. With the care of a child or teen, it is important that a parent researches what may be causing a child’s orthopedic symptoms; the possible non-surgical treatment options that can help the teen athlete back to activity; and which specialty is best trained to treat the teen athlete or injury child. 

Secondly, it is important for the parent to understand that children and teens are NOT adults, and the orthopedic care provided to adults may be completely inappropriate for children and teen athletes because they have growth plates. 

This explains the emergence of the specialty of Pediatric Orthopedics, which is distinctly separate from general orthopedics for the adult patient. 

It's unlikely that a small town or rural city will have a fellowship-trained pediatric orthopedic surgeon as we have with Varsity Orthopedics, because these specialists are typically located in a major city like Dallas Fort Worth and attract patients from a 100-mile radius who need this specialized care. 

The first step for a parent is to identify a fellowship-trained pediatric orthopedic surgeon as it is certainly worthwhile to make the necessary trip when your child or teen athlete has an orthopedic problem.

Understanding how to use the Internet as a source of information is a challenge, however. 

While the Internet can hold a tremendous amount of helpful information, it can equally hold a lot of bad information that can confuse and mislead a healthcare consumer. 

For example, a person planning a long trip might use TripAdvisor to access other traveler's comments and opinions about hotels, resorts and restaurants. Same for using Yelp to get another’s opinion about where to go for a burger.

But is a person's rating of a meal the same as that person’s ability to understand diagnosis and treatment of complex orthopedic problems specific to pediatric orthopedics? 

When a parent is told something they don’t want to hear — such as a teen athlete having overuse syndrome from excessive training encouraged by a overly enthusiastic parent — they can be vindictive and intent on slandering a physician online. 

This leads to the very problematic issue of Internet complaint boards like Healthgrades, Vitals and RateMDs that have emerged over the last five years under the guise of trying to be an indicator of medical quality.

Parents may be surprised to learn that these boards often publish incorrect information about a physician, and at the same time prevent a physician from easily correcting it because the complaint board doesn't answer the phone or have any staff dedicated to human interaction. Some of these boards are simply in the business of selling advertising, and have little interest in the accuracy of posts. These businesses are bought and sold for the profit they bring in from online ads.  If a physician or his staff eventually succeed in contacting a human to correct information or remove a slanderous post, the complaint board often cites that legally they can post whatever they like and have no obligation to change anything.

Instead of providing quality indicators, they have only succeeded in soliciting eyeballs for the online advertising they sell, which is how they make their money. The problem is that they are confusing patients.  

Case in point: One survey found that 62 percent of patients are using online reviews in complaint boards as their first step in choosing a doctor, and 19 percent use complaint boards like YELP, Vitals, Healthgrades and RateMDs to validate their choice before making an appointment. Unfortunately, however, studies are now revealing that such complaint boards are not indicators of physician quality simply because consumers don’t have the data to judge quality of medical care.

A recent 2017 study conducted by ConsumerMedical, a leading health care decision support company, revealed that there may actually be an INVERSE correlation to quality as featured by complaint boards. 

The ConsumerMedical study found that vast majority of top-rated specialty physicians on Yelp, Vitals and Healthgrades are NOT the highest ranked physicians when it comes to examining actual clinical outcome data related to their medical specialty.

In the study, ConsumerMedical identified the top 10 ranked physicians on Yelp, Vitals and Healthgrades across five common specialties in New York, Chicago, and Los Angeles. They then compared these complaint board rankings to a list of the 10 physicians with the highest clinical outcome scores in the same cities. The ConsumerMedical clinical ranking was based on more than 5 billion data points that measure physician performance on variables such as: patient readmission rates; surgical infection rates; average length of stay; procedure volume; and functional status outcomes. Only 2 percent of physicians ranked as top 10 by Yelp, Vitals and Healthgrades showed up as top performers when examining actual clinical outcomes.

“This research confirms what we have long suspected,” concludes David Hines, CEO of ConsumerMedical. “Online patient reviews tend to reflect a patient’s care experiences, such as the physician’s bedside manner. While these attributes are important, they are simply not the main indicators of a physician’s overall quality; sadly you can have a very kind orthopedic surgeon whose patients have hospital readmission rates that are through the roof.” 

So the healthcare consumer needs to be mindful that complaint boards indicate merely the bedside manner of the physician rather than quality of care.

In this respect, we advise the healthcare consumer to be aware that not all information they find on the Internet is accurate or helpful, and some of it can be, in fact, misleading.


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