Rating the Ratings

Ask any business owner or service provider what they think of Yelp and you will likely hear, “It’s complicated,” accompanied by a deep sigh.  While most businesses are happy for the boost in business that comes with a high rating, bad reviews are almost impossible to remove – even if their claims are unfair or inaccurate.  Studies consistently show that unhappy customers are 21% more likely to leave a review than happy customers (Review Trackers, 2018).  It is one thing to rely on online reviews before you try a new pizza place, but what does it mean when we turn to online reviews to choose a mental health treatment provider? When we are talking about potentially life-changing relationship, should we not seek out a regulated and unbiased system for tracking efficacy and quality of care? 

A recent journal article in the Journal of General Internal Medicine highlights a yet-untapped resource for those seeking mental health support: patient ratings. Researchers identify a problem many potential patients and their families face when selecting a treatment center: the lack of information about quality of care.  

“Importantly, because addiction treatment services have traditionally been provided through a system that runs in parallel to ‘mainstream’ medicine and are often overseen by non-medical staff, many patients, family members, and clinicians are unable to determine the quality of care provided in specialized drug treatment facilities (SDTFs) … Just as people frequently turn to the internet to share their experiences and opinions about traditional consumer goods, they also use the internet to share their experiences and opinions about health services.”  (Chen & Fiellin, 2020, p. 1633)

Because there is no readily accepted comprehensive evaluation system, the researchers turned analyzed Yelp and Google Reviews to see what could be gleaned from commercial rating systems that might be useful from a patient-centered healthcare lens. Data researchers analyzed the online ratings of hundreds of treatment centers in Pennsylvania in order to identify important themes. 

“Themes most correlated with 5-star reviews related to focus on recovery (r = 0.53), experiencing a life-changing moment (r = 0.32), staff helpfulness (r = 0.43), compassionate care (r = 0.37), and professionalism (r = 0.29). On the other hand, themes most correlated with 1-star reviews highlighted concerns around wait time (r = 0.41), poor accommodations (r = 0.26), poor phone communication (r = 0.24), medications offered (r = 0.24), and appointment availability (r = 0.23).” (Chen & Fiellin, 2020, p. 1634)

These reviews do seem to indicate that reviews reflect healthcare quality factors that could likely be part of a more official quality-of-care survey, but there are inherent limitations to the information that can be found in these reviews. 

Reliance on internet reviews for healthcare advice should always be done with great caution and care. The format of online reviews leaves much to be desired.  Inherent issues include bias, stigma surrounding addiction, paid advertising component, subjective experiential perspectives, and the less-than-scientific five-star rating system, to say nothing of the ad-banners and sponsored-content surrounding the reviews. 

Chen and Fiellin underscore the issue: “Particularly online, in the absence of other reliable quality indicators, people may lean heavily on information gleaned from review sites and other digital sources as their only means of evaluating a service and may be at increased risk for misdirection and patient brokering,” (Chen & Fiellin, 2020, p. 1633).  It is one thing for that new pizza place to use Yelp to make you want a half-priced order of breadsticks, but it is an entirely different ethical situation when your life is on the line. 

So why is it that when it comes to mental healthcare, we have little access to real data, and we must rely solely on “customer satisfaction” reviews on sites Yelp and Google Reviews?  Chen and Fiellin offer us the priority: transparency.  At New Paradigm Recovery we work closely with other reputable mental healthcare providers in order to maintain transparency through an elevated level of care.  We welcome any unbiased and regulated system which would empower patients with access to information about quality of care in an appropriate context, without click-baiting and advertisements.  Why?  It is simple: we engage in the practice of changing people’s lives.  As their lives change, they join our family and become empowered through a new life and new happiness.  This is our goal.  

So … look online for a good pizza, but open discussions and dialogue are what provide us with the path to quality mental healthcare and the new freedom that it provides. 

References

Chen, K. M., & Fiellin, D. A. (2020). Rate Your Addiction Treatment Facility: Exploring the Quality Chasm Online. Journal of General Internal Medicine, 35, 1633-1634.

Review Trackers. (2018). 2018 ReviewTrackers Online Reviews Stats and Survey. From Review Trackers: https://www.reviewtrackers.com/reports/online-reviews-survey/

1 Patient brokering is a practice of a mental health facility paying for a client or patient

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