Good, Better, Best
Why a bad online review is better than none at all
When scouring online reviews of products, avoid any with no reviews. They are
likely low quality because consumers with bad experiences tend to refrain from posting
a review. That's a finding of recent research from Ritu Agarwal, Robert H. Smith
Dean's Chair Professor of Information Systems and director of the Center for Health
Information and Decision Systems, and Guodong “Gordon” Gao, assistant professor
in the Department of Decision, Operations and Information Technologies.
The researchers, who call the bias the “sound of silence” effect, isolated it
by comparing online reviews of physicians from RateMDs.com with data from an offline
patient survey. In other words, they put online ratings with actual quality side
by side and discovered that doctors who rated low in the patient survey were less
likely to be rated online.
Agarwal and Gao also found that online ratings skewed excessively high or low
because of what they call the hyperbole effect: the likelihood of patients who have
extreme experiences to rate online, and the tendency of consumers who are overwhelmingly
happy or upset to exaggerate their experiences.
“The medical community is so worried that ratings websites will become a channel
for disgruntled patients to vent and ruin their reputations, but we find just the
opposite,” Gao said. “It's more likely that patients are recommending their doctors
rather than 'naming and shaming.' Hopefully our findings will alleviate doctors'
The findings have broad implications for all types of word-of-mouth ratings and
online reviews (think of Amazon product reviews, Yelp restaurant reviews, Hotels.com
ratings, etc.). The research shows that, even fraught with biases, online reviews
can help consumers make better decisions.
“If you can use the information to separate bad from average to good, then online
reviews are very helpful,” said Gao. “But they are less useful if you want to distinguish
among the very best.”
The online reviews offer consumers more information for making choices, which
has become a major element of health-care reform.
“Overall, the trend is toward empowering patients,” said Gao. “This is right
in line with health-care reform, where the vision is that you can choose your insurance
using health insurance exchanges and your physician based on his or her quality
outcomes. Patients need information.”
The information is also critical for doctors, who are keeping close watch on
their online reputations — and not just for vanity's sake. “Your relationship with
your doctors determines whether you listen to them, how much you confide in them,
and whether you are compliant with all of the recommendations they give regarding
medications and more,” said Agarwal.
Beginning next year, major insurers and the Centers for Medicare and Medicaid
Services (CMS) will use “patient experience” ratings as one of the measures for
how much doctors get reimbursed. “That's a great motivator,” she said.
As part of the federal Patient Protection and Affordable Care Act reforms, CMS
set up a provider directory and ratings website called Physician Compare, but the
sites are still being populated. In the meantime, ratings website likeHealthgrades.com,
Yelp.com, RateMDs.com and others will be increasingly important channels for consumers