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Getting To A 5-Star Rating

Most of the telemedicine platforms utilize some sort of rating system on a 5-star rating scale. The professional as well as the client both get to rate each other and often that information is available to either party.

The reason for this post is that I recently had a drop on my 5-star scale. I was able to connect with someone at one of the telemedicine groups who provided me with some brilliant hints and now I have one of the highest ratings on that silly 5-star scale.


The arbitrary 5-Star System

The 5-star system is a bit of a gimmick and too simplistic to capture the essence of an interaction.

The 5-star scare isn’t just used on telemedicine platforms but also online to rate clinicians. Googling my name shows my 5-star rating on various independent websites. And on occasion there are some comments to justify the rater’s rating.

No matter how silly it seems, some sort of rating system will represent us for the foreseeable future. It’s better to learn how to game it properly.


Gaming The 5-Star Scale

The 5-star system is like any other patient satisfaction score such as the Press Ganey score or a MAPPS score used by Kaiser Permanente. 

The purpose of this post isn’t to discuss how to become a better provider but how to game the 5-star system. I learned some tricks from an expert and I want to share that with you guys.

1. Provide Customer Service Not Just Medical Information

When you’re doing a telemedicine visit or even a F2F visit, you are providing a service to an individual. Just because you know that the picture of a rash in front of you is 100% genital herpes and you have the right medication for the patient, don’t assume you provided customer service.

Of course the backbone of any visit is health care but often patients aren’t focused on the health care as much. It matters to them what your bedside manner is because they can’t compare your knowledge to every other doctor’s knowledge. All they have to go on is your bedside manner.

Your bedside manner (your customer service) will determine 99% of your competency.

I provide customer service by following the patient’s agenda instead of my own. They paid for the visit so they get to set the pace.

2. Feel Out The Patient’s Mood

It’s important to feel out the patient’s mood in order to make the visit more efficient. Are they mad? Are they afraid? Are they bewildered? Are they anxious? Are they detached?

With this information I can anticipate where our conversation might go south. I can address their emotional state and connect with them. If I am overly jovial while they are depressed then we’re going to clash.

3. Find Out The Reason For Their Visit

They might be wanting to talk about their cold & flu symptoms but the reason they wanted a telemedicine consult was because they are afraid they have asthma or COPD or lung cancer.

I recall a patient who had a UTI and some blood in the urine. I couldn’t understand why I couldn’t get out of the exam room faster. I calmed down and finally realized that they weren’t worried about the UTI but about possible cancer because of the blood. She left very happy and relieved once I stopped pushing my agenda and followed hers.

4. Make The 5-star Decision For Them

Perhaps the most impressive thing I learned from the customer service expert was that I should tell the client that I want a 5-star service and nothing else will do.

“My goal is to have provided you with a 5-star service and nothing less. If I haven’t been able to achieve that please let me know how I can reach a 5-star level.”

This one simple sentence has shot my average rating from 4.52 up to 4.83 on one of the telemedicine websites.

5. Ask For Feedback

Ask the customer if you answered their question. You may have given them an answer but it may have answered a different question than what they had in mind.

“I want to make sure that I addressed the issue you were concerned about. Please let me know if I am on the right track here.”

Sometimes the client isn’t happy with the answer you gave. They just might not have wanted to hear that the picture they uploaded is a classic genital herpes rash. Let them know you can understand their worry or shock but you are happy to address any questions you have regarding it.

“I understand that the term “genital herpes” isn’t pleasant nor the possible diagnosis of it. But please tell me what questions you have regarding the rash and I’m happy to address them.”

Never let a client leave your exam room or a telemedicine visit without asking whether you provided them with excellent 5-star service. Of course, if you’re going to ask such a question be ready for some feedback and address any gaps without judgement and without being pissy about it.

I always thought it would be so tacky and borderline insulting to make such statements but I have since learned otherwise. And I’m smart enough to not ask that question when the client is obviously still unhappy.

“I want to make sure I’m providing you with an excellent 5-star service. Please let me know if there is anything else I can address.”

6. Don’t Ask For The 5-Star Request Too Early

I have tested this and it’s important to bring up the 5-star topic only after you truly feel that you have addressed all of their reasonable customer service requests.

7. Don’t Reopen The Topic

This one is weird. But it’s important to frame the customer service issue and your request for a 5-star service separate from your clinical interaction.

“I hope that the results of the test will be favorable and I hope that I provided you with a 5-star service.” 


Don’t Take The 5-star Rating personally

It’s okay to feel upset when you get a 1-star review or if you see that your numbers are far lower than that of your colleagues. Know that there are steps you can take to improve it.

Don’t confuse clinical care and customer care. A 5-star rating doesn’t make you a good clinician and a 2-star rating doesn’t mean you’re a shitty clinician. I have always had higher Press Ganey scores but one of my colleagues whom I work with closely is a better clinician than I am but he never had sexy PG scores.


Why The 5-star Rating Matters

Google yourself and look at your current rating. Now google a few colleagues. Don’t you indirectly associate their expertise with their star-rating?

The Rating Reflects On Your Clinical Abilities

When a shitty clinician has a low 5-star rating then I immediately am hit with the confirmation bias that it must be their poor clinical skills that got them that low star-rating.

When I google a new colleague whom I don’t know much about then I assume they must be a good clinician based on their higher star-rating. Of course, I know better, but that’s my subconscious impression.

Less Likely To Get Sued

5-star rating and other patient satisfaction scores matter because they determine how likely you are to get sued. Statistically, clinicians with better patient satisfaction scores are less likely to get sued.

An Easier Patient Interaction

A person who sees that you have a 2-star rating might use it as an excuse to be more resistant during the interaction. This will drain you. If you have a 5-star rating then it’s more likely that they will give you the benefit of the doubt.


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