Fake Online Reviews

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I've been approached by marketing companies to write 5 star reviews on Amazon products in exchange for free products and gift cards. That clued me into the thousands of fake reviews that influence people to buy stuff that is not very good. BBC 5 live Investigates was able to buy a false, five-star recommendation placed on one of the world's leading review websites, Trustpilot.

It also uncovered online forums where Amazon shoppers are offered full refunds in exchange for product reviews. Both companies said they do not tolerate false reviews.

But what about online reviews on doctors? Can they be trusted?

Based on one survey, 84% of patients use online reviews to assess a physician and 77% use review sites to find a doctor. Yet the online world of doctor reviews is chock full of fraudulent reviews, both positive and negative. Since there is no way to regulate what goes on the internet, finding a doctor or specialist recommendation online means you can't trust what you are reading. There are a number of "reputation management" companies that will clean your profile and load it with positive reviews for a fee. Some websites promote doctors who pay for the profile and it's impossible to know from reading except that the "sponsored" doctors appear at the top of the list. A disgruntled patient who didn't get a narcotic prescription can write numerous negative reviews under different names and that one patient can ruin a good doctor's reputation. A great doctor can have 3 staff employees who call in sick and create a handful of angry patients who didn't get the appointment they wanted. Bang...bad reviews.

Most physicians hate online rating sites. Not because they are afraid of patient feedback or poor ratings, but because they know it is not a measure of quality. A friendly, pill happy doctor will have lots of happy patients, but may provide very poor evidence based care. A surgeon with a fancy website and a plush office may actually have poor surgical outcomes. We physicians know that "the doctor to the stars" is often the worse clinician. Just look at the outcome for Michael Jackson or all the botched plastic surgery.

So how do you find the right doctor? The old fashioned way of "word-of-mouth" is still the best. A referral from the primary care doctor is golden. Friends who have had a good surgical experience should be listened too. Do you know a surgical nurse? They know who the best surgeons are. The best doctors have hospital privileges (they go through credentialing and scrutiny) and are involved in their local medical societies. Medicine is a team sport and I'm always leery of physicians that are "lone wolves". No-one is looking at them and they are flying solo with your health. Doctors who have been in practice at the same location are usually solid. But even that is changing with corporations employing doctors and the revolving door of doctors coming and going. Sometimes its just trial and error.

I still use the internet reviews to look up doctors and for almost all the products I buy. But I'm aware that everything I read may not be accurate and I can spot fake reviews pretty easily. Just don't make healthcare reviews your only source of information. Try to use the reviews to augment other referral sources.

There is no magic answer for good healthcare but choosing based only on internet reviews is probably the worst way.

Disclaimer: I have 5 star reviews on multiple online sites and have never paid for or altered a review. Even so I don't think it is the only way to find a physician.