Consumers are taking online physician ratings too literally and thus might not be finding the best doctor.

That’s the chief conclusion of a new and detailed study of physician reviews by researchers at Cedars-Sinai in Los Angeles.

From October 2014 to March 2017, researchers tracked doctor ratings on Healthgrades, a consumer ratings website that ranks medical providers from 1-5 stars and cross-matched data to providers listed in the U.S. Centers for Medicare & Medicaid Services’ physician compare tool.

Researchers next compared 212,933 providers, who had at least four reviews evaluating overall patient satisfaction, grouped the providers by medical, surgical and allied health specialties and performed a statistical analysis to examine the distribution of the providers’ average satisfaction scores.

The study found that overall satisfaction ratings consistently skewed positively, fell within narrow ranges and had different distributions across specialties. Scores that appear high might actually be comparatively average or low, effectively misleading patients. For example, if 90% of physicians in a specialty are rated higher than four stars, patients could be misled into thinking the physician they select is at the top of their field.

“Patients put so much trust into ratings, and the stakes are much higher than simply choosing a restaurant,” says Timothy Daskivich, a physician and assistant professor and director of Health Services Research in the Department of Surgery at Cedars-Sinai. “It’s important to interpret this data correctly because selecting the right physician can have a serious impact on health and wellbeing.”

Providers’ satisfaction ratings also differed significantly by specialty group. Median scores for allied health providers (physical therapists, optometrists) were much higher than those of physicians in medical and surgical specialties.

Some of the differences in rankings between specialties might be related to the nature of the work. That may explain why psychiatrists, who field emotional trauma, get lower ratings than chiropractors, who provide physical relief and lots of one-on-one interaction, Daskivich says.

The study comes at a time when consumers increasingly are turning to third-party websites to post reviews of physicians and comments about a wide variety of healthcare services and experiences. Although there has been a proliferation of these third-party sites (including Healthgrades, Zocdoc and Yelp), they often present information based on a small number of reviews and incomplete or unverified information. As a result, many health systems (such as Stanford, Cleveland Clinic and University of Utah) have begun posting more complete ratings and comments from their own outpatient satisfaction surveys.

“Consumers rely increasingly on these scores when choosing a physician and research shows that patients largely trust these ratings as the sole source of information when choosing a physician,” Daskivich says.

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