Doctors should encourage patients to leave reviews on websites that rate their performance because a wider variety of contributors creates a more balanced picture, suggests a new study.

"Doctors shouldn't be scared of these sites," said senior author Dr. Robert Dellavalle, of the University of Colorado Anschutz Medical Campus in Aurora. "As physicians, you need of be aware of what's on these sites and use that feedback to improve your services."

Dellavalle and his coauthors found that the dermatologists whose online ratings they analyzed were typically listed on about two out of five popular websites for rating doctors. They warn that too few reviews may skew a doctor's rating.

Physician rating websites had 6.4 million hits this year, they write in a research letter in JAMA Dermatology. About 61 percent of patients reported using these types of websites to select a doctor in 2014, they note, and about one in five reported using comments to evaluate their doctors.

For the study, the researchers randomly selected 100 doctors from a 2015 list of nearly 12,000 members of the American Academy of Dermatology. They then searched for those doctors on five popular rating websites: ZocDoc.com, Yelp.com, RateMDs.com, Vitals.com and Healthgrades.com.

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On average, each doctor appeared on about two of the websites. In general, the ratings were high with about 3.6 stars out of a possible five.

"I think for the most part patients love their doctors and most of the sites had high ratings," said Dellavalle.

Four of the five websites allow users to also leave comments about the doctors.

Only one of the websites also discouraged doctors from asking for reviews to avoid bias, but the researchers caution that too few reviews may cause one or two good or bad ratings to create an incorrect impression of doctors.

Encouraging all patients to leave reviews would create more transparency between patients and doctors, they write.

The American Medical Association (AMA) told Reuters Health in a statement that patient satisfaction is important to doctors and patients should have credible information so they can be confident in their choice of doctor. But, they caution against relying too heavily on rating websites.

"Online opinions of physicians should be taken with a grain of salt, and should certainly not be a patient's sole source of information when looking for a new physician," said the statement. "There are many good options for patients looking for a new physician. Choosing a physician is more complicated than choosing a good restaurant, and patients owe it to themselves to use the best available resources when making this important decision."

The AMA also noted that it has several policies related to patient ratings of doctors, which include allowing doctors to review information, and for the entities to adopt policies about the accurate use of physician data.