A Yelp A Day Keeps The Patients Away

With the new year comes resolutions and a renewed interest in health and wellness. These reaffirmed commitments to one’s health often include a trip to a health care provider to get the cold, hard news about just how much work there is to be done. More and more often, these health care providers are being found online via review sites like ZocDoc, Healthgrades and, yes, even Yelp.

Yelp is not only the top-ranked review site for restaurants, but it also happens to be the most popular place to look for a health care provider online. With some 1.3 million health care provider reviews, Yelp is used more often than Healthgrades, RateMDs, Vitals and ZocDoc to find a doctor online. As of March 2015, Yelp drove 30,155 visits to a health or medical website per day. That’s a lot of traffic and a lot of clout.

According to three independent surveys conducted by Software Advice, 61 percent of respondents said they turn to Yelp for help in evaluating a doctor before they book their first visit. Another 24 percent said they use reviews “sometimes” or “often.” Nearly half (44 percent) said they’d consider going to a doctor out of their network if reviews were better than in-network doctors, marking a significant increase from only 26 percent in 2013. Eighty-five percent of respondents in the survey said they were at least “moderately likely” to choose one doctor over another based on high ratings and positive reviews.

Yelp’s reign as the ultimate source for finding reliable restaurants, salons, mechanic shops and the like is longstanding. But how reliable are these anonymous peer reviews, and what impact are they potentially having on health care decisions?

Yelp’s impact on all types of businesses has long been a double-edged sword. There have been accusations of negative reviews being planted by competitor businesses, patrons using the power of a negative review to get preferential treatment and disgruntled customers using reviews as a form of payback for situations which may or may not have been the fault of the business owner or employees.

Fans of the animated television show “South Park” may recall a recent episode in which Cartman demands free food in exchange for a positive Yelp review. During the course of the story, an entire army of Yelp reviewers develops — each of whom believes that he or she is the single most important voice of critique on the Internet. It’s funny, but it probably also hits a little too close to home for merchants who have been on the receiving end of an undeserved negative review.

With medical professionals, the potential harm of a biased and uninformed critique goes a step further. As a story on NPR points out, doctors are wary of the proliferation of online rating websites, saying patients simply aren’t equipped to review the quality of care provided and the expertise of the medical professional. In many ways, consumers on Yelp use many of the same criteria they would to rate a restaurant as they do health providers, with how they feel they’ve been treated being a primary concern. It’s far less common to see a reviewer call out a doctor for botched care or a misdiagnosis than it is to see gripes about other aspects of the office visit, like long wait times, how hard it is to score an appointment, clerical and billing errors or the grating behavior of the office staff.

Doctors fed up with the impact these negative reviews can have on their practice have started to fire back. Some have even gone as far as to threaten — or even sue — consumers who post negative feedback about their practices. And they aren’t the first to seek legal action against Yelp reviewers.

In 2015, a carpet cleaning business in Alexandria, Virginia, brought a suit against California-based Yelp requesting the names of anonymous reviewers who had supposedly unfairly bashed the business. Because it was outside the jurisdiction of the Virginia state court, the business was told it could not be forced to reveal the identities of the reviewers and would have to bring its case to California. The decisions, as The Washington Post reported, sidestepped the thorny conflict at the heart of the case: Where do the First Amendment rights of Internet users to speak anonymously end and the rights of a company to defend its reputation begin?

The American Medical Association (AMA) has gotten involved in the issue, urging patients to talk to their doctors about concerns over the quality of their health care, rather than post reviews anonymously. In a statement the AMA said, “choosing a physician is more complicated than choosing a good restaurant, and patients owe it to themselves to use the best available resources when making this important decision.”

Despite the questionable veracity of medical reviews, they have continued to gain in popularity, picking up substantial momentum in the past few years alone — undoubtedly thanks to mobile devices that have made an “in-the-moment” review even more possible. Though Yelp has offered health reviews since 2004, more than half of those that appear on the site have been written in the past two years, getting millions of views each month.

However, a new partnership shows promise for leveling the playing field of online health care provider reviews. ProPublica, which runs interactive health databases, and Yelp recently agreed to a partnership that will allow information from ProPublica to appear on Yelp’s health provider pages. As NPR reports, this will mean that Yelp users will now see objective data about how providers’ practice patterns compare to their peers, as well as the more subjective reviews of patients. As part of the partnership, ProPublica will get unprecedented access to Yelp’s trove of health reviews. The combination of this objective data with opinion-based reviews will hopefully raise the bar on the level of dialogue surrounding health care providers on the site.

With health care expenditures estimated to have reached $3.207 trillion in 2015 and the average annual cost of health care per person hovering around $10,000 — thanks in part to an increasing number of health care plans that offer low monthly premiums but high out-of-pocket deductibles — there’s a lot at stake for review sites, as well as health care professionals, in finding a more reliable way to help potential patients connect with the right caregiver. Regardless of the dollars and cents, there is an ultimate price associated with quality health care, one that cannot be undersold by a snarky review or otherwise.