MHCID Ideation Project 2 : How do patients choose physicians

Jung - How do patients choose physicians? (national survey of enrollees in employment-related health plans, 2003 --> link)

patients rely heavily on family/friend referrals rather than online data when searching for or choosing physicians. However, this pattern may be changing as the availability of information to evaluate physicians is increasing and becoming more available. This is likely the case, especially since this finding was published in 2003.
while the elderly are at the greatest risk for using health care services, they exhibit the least independent judgement related to consumerist behavior and attitudes when making physician decisions.
people generally have a high level of trust in their regular doctor, familiarity carries a lot of weight in the patient experience.
consumers sometimes fail to understand the organization and delivery of care, often rely more on "understandable measures", such as interpersonal skills. This means that the presentation of information regarding analysis of care measures must be very clear and understandable so that it can be used effectively by consumers.

consumers don't trust other consumer's judgments of technical aspects of care but DO trust their judgement about subjective aspects.
The perceived preference for "informal sources of quality information" appears to be driven by a lack of understanding of process-based measures.

while people express interest in performance-based measures, they often base their health care decisions on interpersonal ("art of care") considerations because they feel they lack the ability to understand or use if effectively.

those who have been in the hospital recently are more likely to use individual doctors as a source of information for choosing a physician and less likely to use formal sources of information.
minorities are more active consumers of physician information, study is unclear why.
consumer activism (use of "formal information sources" to make individual decisions) is likely to increase as the access to relevant information to compare physician grows

(Doctor review websites study, 2014 --> link)

20% of patients say physician's ratings are "very important", 40% say the websites are "somewhat important"
online ratings can be frustrating to some physicians who feel that information can be out of date, and they don't have a way to refute the information
patients pick their primary care physicians based on:

(Complexity, Public Reporting, and Choice of Doctors, 2014 --> link)

Studies indicate that quality of physician choice erodes as choice set grows and becomes more complex
four ways that an abundance of comparative information can impair choice quality

consumers may respond to an overload of information by constraining their choice sets in ways that help the decision process but may not lead to optimal choices.

reduced coherence (inconsistent ranking across multiple dimensions)
loss of perspective (diving into detailed data leads to "tunneling")
emotional heuristics (regret avoidance leads to emotionally resonant measures)

They conducted an experiment in which they created a fake website tool for finding doctors. They modeled the information presented about physicians after real website information, and in different conditions increased the complexity and amount of information presented, as well as the number of physicians (options).

they found that consumers have different decision styles. More specifically, some consumers are able to process more complex decisions more effectively than others.
few consumers probed past the roll-up scores to their component measures. This could have been because they didn't think the extra detail would be helpful, but it may have made those consumers miss out on vital information.
patient comments/reviews of physicians are more engaging and draw consumer's attention. We need to be careful to design the information visualization such that the qualitative information does not take away from the quantitative.

MHCID Ideation Project 2