Most pediatric gastroenterologists would think that the acronym PEWS referred to “Pediatric Early Warning Score” which is used to identify patient deterioration (Sensitivity of the Pediatric Early Warning Score to Identify Patient …).  This PEWS has been an important  achievement in patient safety contributing to lower mortality, reduced codes, and shortened intensive care unit stays (Simple Scoring System and Action Algorithm Identifies Children at …).

PEWs acronym also refers to “physician evaluation websites.”  These type of scores are growing in importance and may also reflect quality care.  As such, a recent article highlights this emerging phenomenon (Am J Gastroenterol 2013; 108: 1676-85 -thanks to Ben Gold for this reference).  While physicians are concerned about their reputations, these websites have not been widely embraced.  This article makes several points about why physicians may need to reconsider.

Key points:

• 35 websites met criteria to be included in this study: 18 were dedicated physician evaluation websites, 5 were health information websites, and 12 were general information websites (eg. Angieslist.com, kudzu.com, yelp.com).
• Frequent analysis/questions besides demographics/affiliations: punctuality, quality of staff (office/nursing), bedside manner, ability to make correct diagnosis, spent sufficient time, costs
• Five sites allow physician feedback and chance to respond to dissatisfied patients: docspot.com, doctorscorecard.com, healthgrades.com, ratemds.com, and your city.md
• Multiple charts indicate the huge traffic on these websites.  For dedicated PEWs, healthgrades.com has the highest volume at over 5 million unique visitors per month (2011-2012).
• Most online evaluations are completed by females (with at least some college education) with a peak age between 45-65 years.  Some smaller PEWs attract a younger crowd (eg. Zocdoc.com -4th most visited dedicated PEW).
• Most evaluations are positive.  “Site administrators…self-reported figures…ranged from 60-75% positive, 4-22% neutral, and 9-21% negative.”

Unique Aspects:

• ucomparehealthcare.com (3rd most visited dedicated PEW) allows multiple physician profiles to be analyzed side-by-side.
• docspot.com compiles existing reviews from over 15 other websites.
• healthgrades.com (most visited dedicated PEW) allows users to rate physicians with a star scale but does not allow free response (avoids libelous comments).
• vitals.com -2nd most visited dedicated PEW.
• yourcity.md considered most “doctor friendly.” Prior to publicizing negative comments, this site allow doctors the option to respond publicly or privately; afterwards, the negative review can be revised.  In addition, per user agreement, a negative claim which cannot be substantiated could result in the anonymous reviewer’s name being revealed to the physician or be removed.

One of my mentors told me that the key to patient care was the the 3 A’s: availability, affability, and ability.  PEWs likely can help evaluate the first two A’s.  PEWs allow for constructive criticisms but need to evolve to include other measures of physician performance.  Ignoring PEWs would be a mistake for physicians –they are here to stay.

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• Why I blog | gutsandgrowth
• Why Social Media is Important for Doctors | gutsandgrowth