There’s more to quality than five stars

January 23, 2018

I recently received an email from a “review concierge.” In this email, they provided me with my “review report card” (I got an A!) and offered their services to help me improve my grade so it would “truly reflect [my] quality of care.” The existence of a company that would solely focus on enhancing my (and other physician’s) online reviews certainly highlighted the exponential growth and popularity of online web reviews and social networking. However, the idea patients would utilize these websites as a primary source when researching and looking for “quality” physicians and hospitals worried me. Health care quality is not only defined by the patient experience, but also by numerous other factors, such as evidence-based practice utilization, treatment outcomes, safety events and coordination of care. 

Health care quality consists of two distinct, but overlapping, components: technical and service quality.  Whereas technical quality consists of care that’s committed to using the best scientific and clinical information available in the service of the patient, service quality is the myriad characteristics that shape the experience of care for each patient and their loved ones. Because many patients may not feel qualified to judge the “technical” aspect of care, they instead assess their health care by other dimensions that reflect what they personally value, such as how they’re treated as a person versus their symptoms or disease. The distinction between these types of quality is important because online physician/hospital review websites most likely reflect the service quality (i.e., wait times, facility appearance, communication, etc.) of the physician/hospital, and although it is an extremely important aspect of care, it is only “one slice of the quality pie.”

If looking for a new physician/hospital, it’s important to do your research. The health care system is not easy to navigate, and although logging in and googling may be an easy and convenient approach to finding a potential physician/hospital, it’s not necessarily the best or safest way to research potential health care resources for you or your loved ones. Once you’ve identified your or your child’s medical needs:

  1. Compile a list of potential physicians/hospitals:
    • Ask your family and friends about their past physician/hospital experiences and recommendations. Because they personally know you, they may be able to suggest a physician/hospital that would best meet your medical needs and expectations.
    • Find physicians through the closest academic hospital or medical center’s website.  Most physicians can be searched both by their specialty, and academic or research interests.
    • If you or your child has a specific, medical need (i.e., heart surgery), search for the top physicians/hospitals that regularly care for and successfully treat patients with similar diagnoses.   
    • Review the list of physicians/hospitals in your medical plan. Health care is expensive and ensuring that your insurance covers the physician/hospital costs is extremely important.
  1. Research the physician:
    • Check the physician’s credentials, such as the validity of his/her medical license, years in practice, and previous grievances and disciplinary action. Most of this information, as well as the physician’s medical school, residency, and fellowship programs, can be found on your state’s medical board website. For the state of Texas, go to
    • Although board certification is not required to practice medicine, it demonstrates a physician’s “exceptional expertise in a particular specialty and/or subspecialty of medical practice.” To verify the physician’s board certification, go to the American Board of Medical Specialties ( website.
    • Review consumer, government and medical plan websites for physician and medical practice quality and performance measures.
    • Ask the physician about hospital affiliations and privileges (or hospitals where he/she admits patients), clinical and research interests, availability of appointments, and after-hours support.
  1. Research the hospital:
    • Ensure the hospital is accredited by the Joint Commission, an independent, nonprofit organization that evaluates and accredits nearly 18,000 health care organizations and programs in the United States. Through on-site reviews, the Joint Commission ensures that the health care organization is meeting certain quality, performance standards.  Hospital accreditation can be found at
    • Look for hospitals with magnet designation, an award that “recognizes health care organizations for quality patient care, nursing excellence and innovations in professional nursing practice.” Hospitals with magnet designation can be found at
    • Compare hospital quality measures on consumer and government websites such as the Hospital Compare website ( which publishes quality measures at over 4,000 Medicare-certified hospitals across the country. 
    • Ensure the hospital has experience with your or your child’s condition. Review state, consumer or hospital websites about the hospital’s performance measures, such as the number of patients/procedures treated or performed annually, complication and readmission rates, mortality rates, and long-term survival rates. Texas Children’s Hospital publishes their quality measures at

Word of mouth is probably the most powerful marketing tool in health care, and many online companies and “review concierges” are more than willing to offer their services! Although a pattern of service quality can be gleaned from other patients’ perspectives and previous experiences, further investigation should be performed before choosing or dismissing a physician/hospital. It’s important to remember that many people tend to leave critical comments or reviews when they’ve had poor experiences instead of positive ones, so keep in mind that this could potentially skew your perception while you search. Be persistent in your pursuit for quality excellence — the amount of time and effort you put forth towards finding the best physician/hospital for you or your child will be well worth it! 

Post by:

Katherine Jennifer Leaming-Van Zandt, MD

Dr. Katherine Leaming-Van Zandt is an Assistant Professor of Pediatrics at BCM and, an attending physician in the emergency centers of Texas Children's Hospital.  She also serves as the Medical Director of the TCH West Campus Emergency Center.  

Dr. Leaming-Van Zandt’s academic interests...

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