Correlation Between COVID-19 Mortality Rate and Online Reviews of Doctors

In this edition of The Wired Practice video for MedPage Today, Vanguard CEO Ron Harman King reveals research correlating COVID-19 mortality rate and online patient reviews of doctors. 

Watch the video on MedPage Today

By Ron Harman King, MS, CEO

Our research correlates COVID-19 mortality rate & doctors’ online reviews, giving reason to accept online patient feedback as legitimate

My fellow Americans, it is with the greatest solemnity that I bring you a message from the front lines of today’s revolution.

All across this great land, fellow countrymen and women are rising up to demand their voices be heard. The will of the masses must be dismissed no longer. And so it is with great patriotic pride that I announce that the people’s voices are at last receiving the gravity of consideration that democracy demands.

I’m talking about online patient reviews, of course. Over the last 12 to 24 months I’ve observed an historic trend of significant impact. Since almost the beginning of the internet, my firm has helped healthcare providers improve online reviews from patients.

Back in the old days of 2019 and earlier, a very common request from client physicians was for us to seek to remove a patient’s critical review on websites such as Healthgrades.com, Yelp and RateMDs.

Unless you want to buy Yelp for close to $2 billion, that’s almost always impossible. For review websites to have any credibility, they must publish the bad with the good.

A new wave of acceptance around online doctor reviews

However, rather remarkably, I don’t recall receiving any such request from a doctor for quite a while now. My takeaway is that a new wave of acceptance has overcome the healthcare profession. None of us like public criticism, particular when it’s unfair. Yet online ratings have become a part of routine life for pretty much everyone well beyond healthcare. Who among us does NOT routinely check the ratings of a book for sale on Amazon or the number of recommendations a movie has earned on Netflix before committing to purchase the book or watch the movie?

This is not to say that the knocks on online patient reviews are groundless. To be sure, there is some validity in complaints that reviews are voluntary and not scientifically sampled; that one or two unfair public complaints can unduly harm a doctor’s or hospital’s reputation; that reviewers sometimes make misinterpretations in seeing only part of a bigger picture; and that, in a few cases, it’s questionable as to whether the reviewer was actually a bona fide patient.

Fair enough. But here’s another perspective, perhaps a revolutionary one. We have monitored and formally studied online patient reviews for a long time now. And we’re not the only ones. In point of fact, our observations and conclusions have closely paralleled similar studies in peer-reviewed journals and have been likewise published in some of said journals.

Could patients’ happiness with their doctors have an influence on their mortality?

I’ll not bury the lead any longer. My point here is that commonly held beliefs about, and distrust in, the reliability of online reviews are wrong. Often dead wrong – the opposite of what we and others have found. I hope that is one reason for healthcare professionals recently taking online reviews more seriously.

Let me be first to say that in no way am I citing a cause and effect, that giving your doctor or hospital a good review will inoculate you against anything.

Our latest research provides an example. Would you believe that patients’ level of happiness or dissatisfaction – as generally expressed in online reviews – might be a determinant in who survives COVID-19? I personally would not have until my colleagues and I analyzed the data. What a shock we got.

We compared the rate of COVID-19 mortality rates in 100 of the most populous U.S. communities and cities against the highest and lowest healthcare satisfaction levels as measured by aggregated online patient reviews, or what we call the Happy Patient Index, or HPI. To determine the HPI, we evaluated tens of thousands of online patient reviews and discovered that, on a national basis, the most positive feedback came from reviewers living in the San Francisco Bay Area, Honolulu and Indianapolis, that order.

Conversely in our rankings, we found the unhappiest reviewers in the HPI were living in Bakersfield and Modesto, California, and North Hempstead, New York, in that order.

Where does your city rank?

Next, we compared aggregated online reviews to COVID-19 mortality rates at a certain point in time. The rather astonishing finding was that in every instance, locations with COVID-19 death rates below 1% of all reported novel coronavirus infections had above-average patient satisfaction ratings online. In addition, true to form, residents of areas with mortality rates greater than 5% usually give their healthcare experiences below-average online reviews.

The best performing cities with low mortality rates and a high HPI were, in order, Madison, Wisconsin; Lincoln, Nebraska; and Anchorage, Alaska. The worst performing cities were New York, Detroit and Jersey City.

In full disclosure, I point out a couple of noteworthy outliers. New Orleans scored a relatively high HPI of 3.97 stars out of five possible stars in online reviews but has experienced a mortality rate more than tenfold of cities with the lowest rates. And Bakersfield, California, – remember Bakersfield? – has experience a relatively low mortality rate despite averaging a little more than three stars in online ratings.

COVID-19 mortality rates correlating to online reviews indicates positive patient experience leads to positive outcomes

Let me be first to say that in no way am I citing a cause and effect, that giving your doctor or hospital a good review will inoculate you against anything. But I am saying that our findings are in keeping with other studies finding a correlation between patients’ positive experiences and positive outcomes. Multiple research findings published in the Journal of the American Medical Association and other internationally reputable peer-reviewed journals have shown that patients’ experiences with care, particularly with providers, correlate with adherence to medical advice and treatment plans, especially for patients suffering chronic conditions.

Is this so shocking? Of course not. Studies have long established that patients with better care experiences have better outcomes. For example, a study of patients hospitalized for heart attacks revealed that patients reporting more positive care experiences had better outcomes a year after discharge.

What may be more astonishing to many of you is the relative reliability of online patient reviews. Well, there’s been studies on that, too, including one that revealed patient reviews of hospitals on Yelp.com not only correlate with ubiquitous HCAHPS reviews published and heavily relied upon by Medicare, but the Yelp reviews further furnished helpful patient feedback in 12 areas not found in HCAHPS surveys.

Given these findings, I choose to believe that we who work in healthcare are coming to a hesitant if not peaceful acceptance of online reviews. Let us henceforth regard them not as a force to be reckoned with but to be accepted as a useful tool for healthcare management.

That, my friends, is the sort of quiet revolution I can get behind.