title: Physician choice making and characteristics associated with using physician-rating websites: cross-sectional study.
abstract: BACKGROUND
  Over the past decade, physician-rating websites have been gaining attention in scientific literature and in the media. However, little knowledge is available about the awareness and the impact of using such sites on health care professionals. It also remains unclear what key predictors are associated with the knowledge and the use of physician-rating websites.
  
  
  OBJECTIVE
  To estimate the current level of awareness and use of physician-rating websites in Germany and to determine their impact on physician choice making and the key predictors which are associated with the knowledge and the use of physician-rating websites.
  
  
  METHODS
  This study was designed as a cross-sectional survey. An online panel was consulted in January 2013. A questionnaire was developed containing 28 questions; a pretest was carried out to assess the comprehension of the questionnaire. Several sociodemographic (eg, age, gender, health insurance status, Internet use) and 2 health-related independent variables (ie, health status and health care utilization) were included. Data were analyzed using descriptive statistics, chi-square tests, and t tests. Binary multivariate logistic regression models were performed for elaborating the characteristics of physician-rating website users. Results from the logistic regression are presented for both the observed and weighted sample.
  
  
  RESULTS
  In total, 1505 respondents (mean age 43.73 years, SD 14.39; 857/1505, 57.25% female) completed our survey. Of all respondents, 32.09% (483/1505) heard of physician-rating websites and 25.32% (381/1505) already had used a website when searching for a physician. Furthermore, 11.03% (166/1505) had already posted a rating on a physician-rating website. Approximately 65.35% (249/381) consulted a particular physician based on the ratings shown on the websites; in contrast, 52.23% (199/381) had not consulted a particular physician because of the publicly reported ratings. Significantly higher likelihoods for being aware of the websites could be demonstrated for female participants (P<.001), those who were widowed (P=.01), covered by statutory health insurance (P=.02), and with higher health care utilization (P<.001). Health care utilization was significantly associated with all dependent variables in our multivariate logistic regression models (P<.001). Furthermore, significantly higher scores could be shown for health insurance status in the unweighted and Internet use in the weighted models.
  
  
  CONCLUSIONS
  Neither health policy makers nor physicians should underestimate the influence of physician-rating websites. They already play an important role in providing information to help patients decide on an appropriate physician. Assuming there will be a rising level of public awareness, the influence of their use will increase well into the future. Future studies should assess the impact of physician-rating websites under experimental conditions and investigate whether physician-rating websites have the potential to reflect the quality of care offered by health care providers.
authors.affiliation: Institute of Management-IFM, School of Business and Economics, Friedrich-Alexander-University Erlangen-Nuremberg, Nuremberg, Germany. Martin.Emmert@wiso.uni-erlangen.de
authors.forename: Martin
authors.initials: M
authors.lastname: Emmert
authors.forename: Florian
authors.initials: F
authors.lastname: Meier
authors.forename: Frank
authors.initials: F
authors.lastname: Pisch
authors.forename: Uwe
authors.initials: U
authors.lastname: Sander
mesh_terms: D000328:Adult; D002755:Choice Behavior; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D020407:Internet; D008297:Male; D008875:Middle Aged; D010820:Physicians; D011795:Surveys and Questionnaires
keywords: patient satisfaction; physician choice making; physician-rating website; public reporting