How do physician demographics, training, social media usage, online presence, and wait times influence online physician review scores for spine surgeons?

An examination of negative one-star patient reviews for foot and ankle orthopedic surgery: A retrospective analysis

BACKGROUND

Despite the questionable validity of online-based physician review websites (PRWs), negative reviews can adversely affect a provider's practice. Several investigations have explored the effect of extremely negative "one-star" reviews across subspecialties such as adult reconstruction, sports medicine, and orthopaedic traumatology; however, to date, no study has explored one-star reviews in foot and ankle surgery. The goal of this study was to characterize factors that contribute to extremely negative, one-star reviews for foot and ankle surgeons on Vitals.com.

METHODS

A retrospective analysis of negative one-star reviews with corresponding patient complaints for foot and ankle surgeons (both orthopaedic surgeons as well as podiatrists) in the United States. Physicians included were selected within a 10-mile radius of the top ten largest cities in the United States. Data was stratified by patient type (e.g., those receiving surgery and those not undergoing surgical intervention) and binned according to type of patient complaint, as previously described.

RESULTS

Of the 2645 foot and ankle surgeons identified in our initial query, 13.8% of surgeons contained one-star reviews eligible for analysis. Patient complaints related to bedside manner and patient experience are the causative factors accounting for 41.5% of the one-star reviews of foot and ankle surgeons for nonsurgical-related complaints. Surgical complications and other outcomes-related factors comprised roughly 50% of the complaints related to surgical patients.

CONCLUSION

In conclusion, complaints related to bedside manner and patient experience are the causative factors accounting for 41.5% of the one-star reviews of foot and ankle surgeons for nonsurgical-related complaints. Surgical complications and other outcomes-related factors comprised roughly half of the complaints related to surgery. This data serves to inform practicing foot and ankle surgeons as to the influences behind patients leaving extremely negative reviews on PRWs.

LEVEL OF CLINICAL EVIDENCE

IV.

Assessing reviews of academic oral and maxillofacial surgeons within the US on Healthgrades

PURPOSE

The purpose of the following study was to explore the patient feedback on academic oral and maxillofacial surgeons (OMSs) practicing in the United States (US) using the physician rating website (PRW) Healthgrades.com.

METHODS

We conducted a retrospective cohort study on academic OMSs in the US using data from Healthgrades.com. Predictor variables included OMS characteristics or rating characteristics. The primary outcome variable was overall rating. Linear regression was used to determine independent predictors of overall rating.

RESULTS

The final study sample consisted of 309 academic OMSs (mean age, 56.4 years; males, 86.4%). Age group was significantly associated with overall rating (p = 0.034). Dual-degree OMSs had a higher mean overall rating than single-degree OMSs (4.26 vs. 3.98, p = 0.012). The number of ratings was also significantly associated with overall rating (p = 0.019). Upon controlling for all other variables, merely age group was independently associated with overall rating. Specifically, OMSs aged 41-55 years were associated with a higher overall rating (+0.96, p = 0.022) relative to OMSs aged >70 years.

CONCLUSIONS

The OPRs on Healthgrades.com for academic OMSs within the US are generally positive. Age was the only independent predictor for overall rating - younger OMSs (aged 41-55 years) were independently associated with a higher overall rating relative to older OMSs (aged >70 years). The new generation of younger OMSs is likely to be aware of PRWs and their implications in the growing world of online exposure.

Association Between Social Media Activity and Ratings on Physician Review Websites Among Orthopaedic Surgeons With an Active Online Media Presence

Background

Social media has the potential to play a substantial role in the decision-making of patients when choosing a physician for care.

Purpose

The purpose of this study was to determine whether an association exists between physician social media activity and patient satisfaction ratings on physician review websites (PRWs) as well as number of reviews. It was hypothesized that there would be a significant association between physician social media utilization and patient satisfaction ratings.

Study Design

Cross-sectional study.

Methods

The American Orthopaedic Society for Sports Medicine database was queried for the complete membership list. The online media profile and level of activity of the members were evaluated, and an online media presence score was calculated. The surgeons with the approximately top 10% of online media presence scores were compiled to assess the relationship between social media usage (Twitter, Instagram, YouTube, and Facebook) and patient satisfaction ratings on the Google Reviews, Healthgrades, and Vitals PRWs. Bivariate analysis was performed to compare demographic variables and level of online presence.

Results

A total of 325 surgeons were included in the analysis. The most common platform used was Facebook (88.3%). There was no significant relationship between active social media use and overall ratings on any of the PRWs. Active Twitter use was associated with a greater number of ratings on all review websites, a greater number of comments on Google Reviews and Healthgrades, and shorter patient-reported clinic wait times on Healthgrades. Active Instagram use was associated with a greater number of comments on Vitals. No relationships were observed for YouTube or Facebook.

Conclusion

For the included sports medicine surgeons who were most active on social media, no significant relationships were found between social media use and overall ratings on PRWs. Of all the platforms assessed, active use of Twitter was the only significant predictor of more reviews on PRWs. Thus, when deciding which form of social media engagement to prioritize in building one's practice, Twitter may serve as a relatively low-demand, high-reward option.

Instagram Outperforms Twitter in Driving Social Media Engagement Among Sports Medicine Orthopaedic Surgeons

Purpose

To determine the content posted by sports medicine orthopaedic surgeons on Instagram and Twitter and to evaluate the associated engagement.

Methods

Data were collected from sports medicine orthopaedic surgeons' Instagram profiles and Twitter profiles between December 2020 and June 2022. The median number of total number of likes, comments, and retweets was calculated. The content of posts from both platforms was divided into the following categories: personal life, research, patient testimony, day in the life, pathway to becoming a physician, clinical cases, medical facts, and team coverage.

Results

Data from 71 Instagram profiles and 39 Twitter profiles were used in this study. A total of 1,193 posts were identified on Instagram and 1,284 posts were identified on Twitter. The personal life category had the greatest number of posts on Instagram (303, 25.4%), whereas the medical facts category had the greatest number of posts on Twitter (251, 19.5%). Pathway to becoming a physician had the greatest median number of likes on both Instagram (97.5, range 48-2,467) and Twitter (19, range 0-50) and the greatest median number of comments on Instagram at 16 (range 1-203). The team coverage category on Instagram had the greatest percentage of likes per follower at 9.9%. A significantly greater percentage of orthopaedic surgeons posted about day in the life content, medical facts, and research on Twitter in comparison with Instagram. Instagram resulted in significantly more social media engagement than Twitter in all 8 categories (P < .05).

Conclusions

Instagram resulted in significantly more social media engagement across all categories in comparison with Twitter with team coverage, personal life, and pathway to becoming a physician being the most popular categories.

Clinical Relevance

The information learned in this study may help sports surgeons understand how they may best utilize social media to engage with others and enhance their clinical practice.

How Are Patients Reviewing Spine Surgeons Online? A Sentiment Analysis of Physician Review Website Written Comments

STUDY DESIGN

A Sentiment Analysis of online reviews of spine surgeons.

OBJECTIVES

Physician review websites have significant impact on a patient's provider selection. Written reviews are subjective, but sentiment analysis through machine learning can quantitatively analyze these reviews. This study analyzes online written reviews of spine surgeons and reports biases associated with demographic factors and trends in words utilized.

METHODS

Online written and star-reviews of spine surgeons were obtained from healthgrades.com. A sentiment analysis package was used to analyze the written reviews. The relationship of demographic variables to these scores was analyzed with t-tests and word and bigram frequency analyses were performed. Additionally, a multiple regression analysis was performed on key terms.

RESULTS

8357 reviews of 480 surgeons were analyzed. There was a significant difference between the means of sentiment analysis scores and star scores for both gender and age. Younger, male surgeons were rated more highly on average (P < .01). Word frequency analysis indicated that behavioral factors and pain were the main contributing factors to both the best and worst reviewed surgeons. Additionally, several clinically relevant words, when included in a review, affected the odds of a positive review.

CONCLUSIONS

The best reviews laud surgeons for their ability to manage pain and for exhibiting positive bedside manner. However, the worst reviews primarily focus on pain and its management, as exhibited by the frequency and multivariate analysis. Pain is a clear contributing factor to reviews, thus emphasizing the importance of establishing proper pain expectations prior to any intervention.

Using Sentiment Analysis to Understand What Patients Are Saying About Hand Surgeons Online

BACKGROUND

Physician review websites have influence on a patient's selection of a provider. Written reviews are subjective and difficult to quantitatively analyze. Sentiment analysis of writing can quantitatively assess surgeon reviews to provide actionable feedback for surgeons to improve practice. The objective of this study is to quantitatively analyze large subset of written reviews of hand surgeons using sentiment analysis and report unbiased trends in words used to describe the reviewed surgeons and biases associated with surgeon demographic factors.

METHODS

Online written and star-rating reviews of hand surgeons were obtained from healthgrades.com and webmd.com. A sentiment analysis package was used to calculate compound scores of all reviews. Mann-Whitney U tests were performed to determine the relationship between demographic variables and average sentiment score of written reviews. Positive and negative word and word-pair frequency analysis was also performed.

RESULTS

A total of 786 hand surgeons' reviews were analyzed. Analysis showed a significant relationship between the sentiment scores and overall average star-rated reviews (r2 = 0.604, P ≤ .01). There was no significant difference in review sentiment by provider sex; however, surgeons aged 50 years and younger had more positive reviews than older (P < .01). The most frequently used bigrams used to describe top-rated surgeons were associated with good bedside manner and efficient pain management, whereas those with the worst reviews are often characterized as rude and unable to relieve pain.

CONCLUSIONS

This study provides insight into both demographic and behavioral factors contributing to positive reviews and reinforces the importance of pain expectation management.

What Makes a 5-Star Orthopaedic Sports Medicine Surgeon? An Analysis of Positive Online Patient Reviews

Background

The increased focus on patient satisfaction has led to growth in the use of physician rating websites.

Purpose

To analyze the factors associated with online 5-star patient reviews for orthopaedic sports medicine surgeons.

Study Design

Cross-sectional study.

Methods

A total of 70 orthopaedic sports medicine surgeons were randomly selected from the AOSSM website. A search was performed for these surgeons on Yelp.com. All reviews other than 5 stars (of a possible 5 stars) were excluded from the study. Each review was categorized as referring to a surgical or nonsurgical aspect of care, and each comment within the review was categorized as being clinically or nonclinically related. Comments were further subcategorized by specific features such as bedside manner, clinical outcomes, and patient education. Categorical variables were analyzed using the chi-square test.

Results

Overall, 400 five-star reviews were included in the study, comprising 1225 total positive comments. Of the 400 five-star reviews, 200 (50%) were from surgically treated patients, and 200 (50%) were from nonsurgically treated patients. Of the 1225 positive comments, 505 (41%) were clinically related, and 720 (59%) were nonclinical. The most common positive clinical comments were for clear treatment plans (191 reviews [48%]), good outcomes (173 reviews [43%]), and providing alternative treatment plans (55 reviews [14%]). The most common positive nonclinical comments were for good physician bedside manner (287 reviews [72%]), friendly/professional staff (194 reviews [49%]), and ease of scheduling (68 reviews [17%]).

Conclusion

The majority of 5-star patient reviews left positive comments regarding nonclinical aspects of care such as physician bedside manner and friendly staff. The most common positive comments regarding clinical aspects concerned good outcomes and clear treatment plans. The overall most common positive comment, in both surgically and nonsurgically treated patients, referred to good bedside manner.

A sentiment analysis on online psychiatrist reviews to identify clinical attributes of psychiatrists that shape the therapeutic alliance

Background

While online reviews from physician rating websites are increasingly utilized by healthcare providers to better understand patient needs, it remains difficult to objectively identify areas for improvement in providing psychiatric care.

Objectives

To quantitatively characterize the sentiment of online written reviews of psychiatrists to determine clinical attributes that can be strengthened to improve psychiatrists' therapeutic alliance with their patients.

Materials and methods

Sentiment scores of 6,400 written reviews of 400 US-based psychiatrists on a US-based online physician rating website were obtained through a natural-language-processing-based sentiment analysis. Relationships among sentiment scores, average star ratings, and demographics were examined. Linguistic analyses determined words and bigrams that were highly associated with reviews with the most positive and negative sentiment.

Findings

Sentiment scores were significantly correlated with average star ratings of the psychiatrists (R = 0.737, p < 0.001). Psychiatrists who were younger (< 56 years old) and/or practiced in the Northeast had significantly higher average star ratings than those older and/or practicing in the Southwest. Frequency analysis showed that positive reviews most frequently contained "time" (N = 1,138) and "caring" (N = 784) while negative reviews most frequently contained "medication" (N = 495) and "time" (N = 379). Logistic regression analysis revealed that reviews were more likely to be considered positive when they included "great listener" (OR = 16.89) and "comfortable" (OR = 10.72) and more likely to be negative when they included "meds" (OR = 0.55) and "side effect" (OR = 0.59).

Conclusion

Psychiatrists who are younger and located in the Northeast receive more positive reviews; there may be potential for demographic bias among patient reviewers. Patients positively rate psychiatrists who make them feel heard and comfortable but negatively rate encounters centered around medications and their side effects. Our study lends quantitative evidence to support the importance of thorough and empathetic communication of psychiatrists in building a strong therapeutic alliance.

Understanding online ratings of joint arthroplasty surgeons: A national cross-sectional analysis

Background

Patient reviews provide an important referral source for physicians and an opportunity to improve practice performance. This study's objective was to characterize the online reviews of hip and knee arthroplasty surgeons published by three of the industry's leading platforms.

Methods

A random sample of 1000 hip and knee arthroplasty surgeons across all 50 US states (10 hip and 10 knee surgeons per state) was generated using Google Search. A total of 7842 online reviews posted for those surgeons on Healthgrades, Vitals, and Google were analyzed. A range of surgeons, affiliated hospitals, and reviewer attributes was compared to identify significant predictors of patient satisfaction.

Results

The study cohort had 98.1% male surgeons with a mean age of 53.55 ± 8.94 years and mean experience of 26.43 ± 9.21 years. Younger age (p < 0.001), shorter years of experience (p < 0.001), and arthroplasty fellowship training (p < 0.001) were associated with more positive ratings. Reviewer anonymity, observed in 30.93% of all reviews, tended to correlate with more negative ratings (p < 0.001). Overall, 86.93% of patient remarks were positive, and only 74.81% of remarks centered on physician attributes. The five leading components of patient satisfaction were perceptions of physician competence (34.81%, p < 0.001), bedside manner (23.83%, p = 0.002), and communication (16.17%, p = 0.94); interactions with physician extenders (14.75%, p < 0.001); and wait time (2.73%, p < 0.001).

Conclusion

While most ratings of hip and knee arthroplasty surgeons were positive, more than a quarter of reviews were either not directly related to the individual surgeons or were submitted anonymously. Caution is advised regarding overreliance on patient experience surveys as predictors of physician performance.

How are Patients Describing You Online? A Natural Language Processing Driven Sentiment Analysis of Online Reviews on CSRS Surgeons

STUDY DESIGN

A quantitative analysis of written, online reviews of Cervical Spine Research Society (CSRS) surgeons.

OBJECTIVE

This study quantitatively analyzes the written reviews of members of the CSRS to report biases associated with demographic factors and frequently used words in reviews to help aid physician practices.

SUMMARY OF BACKGROUND DATA

Physician review websites have influence on a patient's selection of a provider, but written reviews are subjective. Sentiment analysis of writing through artificial intelligence can quantify surgeon reviews to provide actionable feedback.

METHODS

Online written and star-rating reviews of CSRS surgeons were obtained from healthgrades.com. A sentiment analysis package was used to obtain compound scores of each physician's reviews. The relationship between demographic variables and average sentiment score of written reviews were evaluated through t -tests. Positive and negative word and bigram frequency analysis was performed to indicate trends in the reviews' language.

RESULTS

In all, 2239 CSRS surgeon's reviews were analyzed. Analysis showed a positive correlation between the sentiment scores and overall average star-rated reviews ( r2 =0.60, P <0.01). There was no difference in review sentiment by provider sex. However, the age of surgeons showed a significant difference as those <55 had more positive reviews (mean=+0.50) than surgeons >=55 (mean=+0.37) ( P <0.01). The most positive reviews focused both on pain and behavioral factors, whereas the most negative focused mainly on pain. Behavioral attributes increased the odds of receiving positive reviews while pain decreased them.

CONCLUSION

The top-rated surgeons were described as considerate providers and effective at managing pain in their most frequently used words and bigrams. However, the worst-rated ones were mainly described as unable to relieve pain. Through quantitative analysis of physician reviews, pain is a clear factor contributing to both positive and negative reviews of surgeons, reinforcing the need for proper pain expectation management.

LEVEL OF EVIDENCE

Level 4-retrospective case-control study.

Social Media Use Among Hand Surgeons

BACKGROUND

Recently social media use within healthcare has increased significantly. Today, it is common for patients to browse the Internet, including physicians' social media pages, to learn about their medical conditions and search for providers. The purpose of this study is to analyze the use of social media among hand surgeons, and to compare this use between academic and private surgeons.

METHODS

Using the American Society for Surgery of the Hand's (ASSH) online directory, all active members practicing within the ten most populated U.S. cities were identified. Social media presence was determined by an Internet search of platforms. Members were stratified by practice model (academic vs. private). Chi-square and t-tests were used to compare categorical and continuous variables, and a multivariable logistic regression was performed for the binary variable practice model.

RESULTS

Two hundred and fifty-six hand surgeons were identified with 150 (59%) in academic and 106 (41%) in private practice. For ResearchGate accounts, 51 (82%) were academic and 11 (18%) were private. Mean PubMed publications was 38 for academic and 9 for private. YouTube presence was 69 (70%) in academic and 29 (30%) in private. On multivariable analysis, the odds of having ResearchGate and YouTube presence were higher for academic practice. There was no statistically significant difference by practice type for Facebook, Twitter, LinkedIn, and Instagram.

CONCLUSIONS

With the recent social media expansion, surgeons have adopted social media platforms to reach patients. While the literature has shown that private practices are more active in social media, our results show they are not more active than academic practices in the ten most populated U.S. cities.

LEVEL OF EVIDENCE

IV.

Social Media in Orthopädie und Unfallchirurgie

Für die Orthopädie und Unfallchirurgie sind u. a. LinkedIn, Facebook, Instagram, Twitter, YouTube und ResearchGate wichtige soziale Netzwerke. Diese ermöglichen oft eine direktere und raschere Kommunikationsaufnahme unter Ärzten, Physiotherapeuten, Praxen und Krankenhäusern, Fachgesellschaften, Fachzeitschriften, Kostenträgern, Firmen aus der Medizintechnik und pharmazeutischen Industrie sowie Patienten. Durch diese Heterogenität der Anwender eröffnet sich eine Vielzahl an Nutzungsmöglichkeiten: Patientenmarketing, Wissensaustausch, Fortbildungen und Vorstellung innovativer Therapien. Verschiedene wissenschaftliche Studien haben diesbezüglich positive Effekte einer Nutzung sozialer Medien im Hinblick auf Arztbewertungen, Patientenoutcome und Aufmerksamkeit für aktuelle wissenschaftliche Studien (Zitierungen) zeigen können. Fachartikel, deren Inhalt über Infografiken in sozialen Medien platziert wird, werden häufiger zitiert als Artikel ohne Social-Media-Präsenz. Diesen positiven Aspekten der Nutzung sozialer Netzwerke in der Medizin stehen jedoch auch Risiken gegenüber. So haben aktuelle Untersuchungen gezeigt, dass in sozialen Netzwerken wiederholt in hohem Maße unwissenschaftliche und irreführende Informationen kommuniziert werden – Phänomen „fake news“. Für die Nutzung sozialer Medien durch Ärzte gilt es vor allem, im Hinblick auf den Datenschutz, die ärztliche Schweigepflicht und das Heilmittelwerbegesetz besonders achtsam zu sein.

Patient satisfaction reviews for 967 spine neurosurgeons on Healthgrades

OBJECTIVE

Patients are increasingly relying on independent physician rating websites (PRWs) to obtain information about healthcare providers. Healthgrades.com is a widely used PRW that allows patients to rate physicians on various metrics of performance and quality of care. This study categorically investigated the correlations between demographics of spine neurosurgeons and online ratings on Healthgrades to better understand the factors driving patient satisfaction in spine surgery in the United States.

METHODS

In August-December 2019, the authors performed a retrospective data analysis using Healthgrades. The American Association of Neurological Surgeons (AANS) membership database was used to identify spine neurosurgeons in the United States and extract biographical and career data. Individuals with an academic practice were further investigated for academic rank, leadership, and fellowship training. Scores from eight patient satisfaction metrics (PSMs) were collected for each surgeon from Healthgrades.

RESULTS

A total of 967 spine neurosurgeons were included in the study cohort. Patient satisfaction did not correlate with sex, PhD acquisition, academic status, or academic rank. Among those who were academic surgeons, completion of fellowship training was associated with higher ratings. Geographical location of practice did not influence patient satisfaction. Prolonged wait time was an independent predictor of decreased patient satisfaction and was a key confounding variable underlying trends seen with advanced career duration and age.

CONCLUSIONS

Overall, patients rated spine neurosurgeons highly favorably on the Healthgrades website. Due to the emerging role of PRWs in locating and assessing providers, it is important for both patients and clinicians to understand the factors that impact patient experience.

What Are Patients Saying About Minimally Invasive Spine Surgeons Online: A Sentiment Analysis of 2,235 Physician Review Website Reviews

Objective

Physician review websites are becoming increasingly popular for patients to find and review healthcare providers. The goal of this study was to utilize quantitative analyses to understand trends in ratings and written comments on physician review websites for Society of Minimally Invasive Spine Surgery (SMISS) members.

Methods

This is a cross-sectional study. The reviews of SMISS surgeons were obtained from healthgrades.com, and sentiment analysis was used to obtain compound scores of each physicians' reviews. SMISS surgeons who were international or had fewer than three written reviews, often consisting of residents and fellows, were excluded. Inferential statistics were utilized, and word frequency analysis reported the phrases used to characterize reviews.

Results

One hundred sixty-nine surgeons met the inclusion criteria. 98.6% were males and the mean age was 51.7 years old. A total of 2,235 written reviews were analyzed. Younger surgeons were significantly more likely to receive higher star ratings (p<0.01). Positive behavioral characteristics, such as “kind” and “bedside manner,” conferred significantly improved odds of receiving positive reviews (p<0.01). Ancillary “staff” conferred a 2x greater odds of receiving a positive review whereas a comment on “wait” times halved a surgeon’s odds (p<0.01). Sentences describing pain drove down the odds of positive reviews whereas those describing pain relief produced greater odds of positive reviews (p<0.01).

Conclusion

Physicians who were younger, personable, provided sufficient pain relief, and who worked in favorable offices received the most positive reviews. This study informs SMISS members on the traits deemed important by patients who ultimately review surgeons online.

Social Media in Hip Arthroscopy Is an Underused Resource That Enhances Physician Online Reputation

Purpose

To analyze the impact of professional social media (SM) presence, activity level, and physician practice–specific variables on online ratings and rating frequency for hip arthroscopists across 3 leading physician review websites (PRWs).

Methods

The Arthroscopy Association of North America and American Orthopaedic Society of Sports Medicine directories were queried to identify practicing hip arthroscopists. Physicians included were residency-trained surgeons practicing within the United States. Surgeon ratings, comments, and reviews were compiled from 3 PRWs (Google, Healthgrades, Vitals). Google searches assessed for professional Facebook, Twitter, and Instagram accounts and demographic information. Surgeons were considered active if they posted the month before data collection. Logistical regression and a univariate model analyzed effects of demographic factors and other variables on SM use and PRW statistics.

Results

In total, 555 surgeons met inclusion criteria (93.2% male, 6.8% female); 41% had a professional SM account (27.4% Facebook, 24.3% Twitter, 12.1% Instagram). Few surgeons with SM actively posted (30.5% Facebook, 43.7% Twitter, 37.3% Instagram). Surgeons with any SM had significantly greater number of ratings on all review websites (P < .001). Linear regression revealed academic physicians had lower number of ratings (P = .002) and average ratings (P < .001). Instagram users had an average 12.4 more ratings. Surgeons more likely to use SM resided in greater population cities (990 vs 490 [per 1,000]) with higher surgeon density (3.3 vs 2.2).

Conclusions

Most hip arthroscopists have no professional SM, and fewer frequently post content. SM presence significantly increases the number of ratings on PRWs but does not affect overall rating. Surgeons using SM practice in more populous cities with more competition. Academic surgeons had fewer ratings and lower average ratings. A professional Instagram account can increase the number of online ratings.

Clinical Relevance

Understanding how SM presence affects an orthopaedic surgeon’s practice may provide information on how surgeons best connect with patients.

What are patients saying about you online? A sentiment analysis of online written reviews on Scoliosis Research Society surgeons

PURPOSE

Physician review websites have significant influence on a patient's selection of a provider, but written reviews are subjective. Sentiment analysis of writing through artificial intelligence can quantify surgeon reviews to provide actionable feedback. The objective of this study is to quantitatively analyze the written reviews of members of the Scoliosis Research Society (SRS) through sentiment analysis.

METHODS

Online written reviews and star-rating reviews of SRS surgeons were obtained from healthgrades.com, and a sentiment analysis package was used to obtain compound scores of each physician's reviews. A t test and ANOVA was performed to determine the relationship between demographic variables and average sentiment score of written reviews. Positive and negative word and word-pair frequency analysis was performed to provide context to words used to describe surgeons.

RESULTS

Seven hundred and twenty-one SRS surgeon's reviews were analyzed. Analysis showed a positive correlation between the sentiment scores and overall average star-rated reviews (r² = 0.5, p < 0.01). There was no difference in review sentiment by provider gender. However, the age of surgeons showed a significant difference as younger surgeons, on average, had more positive reviews (p < 0.01).

CONCLUSION

The most frequently used word pairs used to describe top-rated surgeons describe compassionate providers and efficiency in pain management. Conversely, those with the worst reviews are characterized as unable to relieve pain. Through quantitative analysis of physician reviews, pain is a clear factor contributing to both positive and negative reviews of surgeons, reinforcing the need to properly manage pain expectations.

LEVEL OF EVIDENCE

IV.

Physician-Rating Websites and Social Media Usage: A Global Survey of Academic Orthopaedic Surgeons: AOA Critical Issues

The relationship between orthopaedic surgeons and the internet is complicated. Social media allows surgeons to educate their patients while marketing to them at the same time. Conversely, patients are able to better communicate with their surgeons while anonymously rating their service and expertise. This study aims to look at the complex relationship between surgeons and social media use.

Social media use by shoulder and elbow surgeons increases the number of ratings on physician review websites

BACKGROUND

The use of physician review websites by patients is increasingly frequent. One potential way for shoulder and elbow surgeons to enhance their online reputation and attract patients is via social media, yet its impact is unknown. This study sought to analyze the effect of social media use on the number of online ratings and overall rating of shoulder and elbow surgeons. We secondarily studied variables affecting social media use.

METHODS

The American Shoulder and Elbow Surgeons directory was probed to identify practicing surgeons. Surgeon evaluation data, including ratings, comments, and reviews, were compiled from 3 physician review websites (Google, Healthgrades, and Vitals). Google was queried to assess for a professional Facebook, Twitter, or Instagram account, as well as obtain information on surgeon training, practice location, and other demographic variables.

RESULTS

A total of 646 surgeons met the inclusion criteria (93.8% male and 6.2% female surgeons). Overall, 37% had a professional social media account (Facebook, 23.1%; Twitter, 24.1%; and Instagram, 9.4%). Linear regression analysis showed that Facebook use correlated with an average increase of 48.6 in the number of ratings. No social media platform correlated with physician rating. The surgeons more likely to use social media were those who graduated residency in 2000 or later (40.8% vs. 29.2%), those who practiced in cities with higher populations (mean, 1188.9 vs. 708.4 [per 1000]), and those with more surgeons practicing in the same city (mean, 7.0 vs. 5.0).

CONCLUSION

The majority of shoulder and elbow surgeons do not have a professional social media account. Those using this platform are younger and located in more populous cities with more competition. Having a professional social media profile was not correlated with ratings, but there was a positive association with the number of online ratings, and Facebook had the strongest association. Surgeon ratings are overwhelmingly positive with minimal variability; therefore, a high number of ratings confirms a surgeon's exceptional reputation. The residency graduation year, city population, and number of nearby surgeons affected ratings, although the absolute differences were minimal. For shoulder and elbow surgeons, a professional social media account correlates with an increase in the number of online physician ratings. Recent graduates practicing in competitive locations may feel increased pressure to leverage this in an attempt to build their practices.

Comparison of Social Media Utilization Among Vascular Surgeons, Interventional Cardiologists, and Interventional Radiologists at Academic Training Institutions

BACKGROUND

Social media platforms, especially Twitter, are increasingly utilized across medical practice, education, and research. However, little is known about differences in social media use among physicians of varying specialties and its impact on recruitment of trainees. Our objective was to describe differences in social media use among vascular interventional proceduralists at academic training institutions.

METHODS

We identified institutions with training programs in vascular surgery (VS), interventional radiology (IR), and interventional cardiology (IC). Faculty providers were identified in each specialty at these institutions. A standardized search was used to identify non-anonymous social media profiles on Facebook, Instagram, and Twitter in September 2019. Influencers were defined as physicians with more than 1,000 Twitter followers. Follow ratio was defined as the number of followers divided by the number of accounts followed. Between-specialty differences were analyzed.

RESULTS

A total of 1,330 providers (n = 454 VS, n=451 IR, n = 425 IC) were identified across 47 institutions in 27 states. Across all physicians, a minority of providers utilize social media (Facebook: 24.9%, n = 331; Instagram: 10.8%, n = 143; Twitter: 18.0%, n = 240). VS were significantly more likely to use Instagram (P = 0.001) but there was not a significant difference in utilization of Facebook and Twitter. Among Twitter users, VS had fewer followers on average (median 178, inter-quartile range [IQR] 39-555) than IR (median 272, IQR 50-793, P = 0.26) and IC (median 286, IQR 71-1257, P = 0.052). IC were most likely to be influencers (30.9%, n = 25) followed by IR (17.9%, n = 15) and VS (10.7%, n = 8, P = 0.006). On average, interventional cardiologists had the highest follow ratio (mean 4.9 ± 7.1) compared to interventional radiologists (mean 3.2 ± 5.5) and vascular surgeons (mean 2.5 ± 3.3, P < 0.001).

CONCLUSION

A minority of academic vascular interventional proceduralists utilize social media in a non-anonymous manner. On Twitter, interventional cardiologists are most likely to be influencers based on number of followers and, on average, have the highest follow ratio. Vascular surgeons could potentially benefit from pursuing greater influence and visibility on social media as a means to recruit trainees.

Correlation between social media utilization by academic neurosurgery departments and higher online patient ratings

OBJECTIVE

Patients increasingly utilize online physician review websites (PRWs) and social media to inform healthcare-related decisions. This provides neurosurgeons with opportunities for increased patient engagement. And despite the growing use of social media among neurosurgeons, the relationship between social media utilization and online reviews remains unknown. The goal of this study was to characterize the relationship between social media utilization and PRW ratings across academic neurosurgery departments.

METHODS

Social media accounts (Twitter, Facebook, YouTube, Instagram) of academic neurosurgery departments were identified. Online reviews for individual faculty were obtained from Healthgrades, Vitals, WebMD, and Google. Reviews were aggregated to identify the total number of reviews per department, to generate a composite departmental rating, and to calculate a summed departmental score. US News & World Report (USNWR) and Doximity rankings were recorded for each department. Social media utilization by individual neurosurgeons and associated ratings were investigated within the departments with the highest social media utilization.

RESULTS

Seventy-eight percent of academic neurosurgery departments utilized social media. The most prevalent platform was YouTube (49.1%), followed by Twitter (46.5%), Facebook (38.6%), and Instagram (16.7%). Higher patient ratings on PRWs were associated with the utilization of YouTube (p = 0.048) or Twitter (p = 0.02). The number of social media platforms utilized demonstrated a significant, positive correlation with patient ratings (p = 0.006) and summed patient ratings (p = 0.048). Although USNWR (p = 0.02) and Doximity (p = 0.0008) rankings correlated with patient ratings, only the number of social media platforms utilized remained a significant predictor of patient ratings on multivariate analysis (p = 0.0001). Thirty-one percent of academic neurosurgeons from departments with high social media utilization were active on social media. The most prevalent social media platform among individual neurosurgeons was Twitter (27.4%), followed by Instagram (8.4%), Facebook (4.9%), and YouTube (2.2%). Higher summed patient scores were associated with individual neurosurgeon utilization of YouTube (p = 0.04), Facebook (p < 0.0001), and Instagram (p = 0.01). Increased social media utilization among neurosurgeons was correlated with a greater number of patient reviews (p = 0.006) and higher summed patient scores (p = 0.003). On multivariate analysis, only Facebook use remained a significant predictor of the number of patient reviews received (p = 0.002) and summed patient satisfaction scores (p < 0.001).

CONCLUSIONS

An increased social media presence is associated with higher ratings on PRWs. As neurosurgeons continue to expand their online presence, they should be aware of the possible impact of social media on online patient reviews.

The impact of social media presence, age, and patient reported wait times on physician review websites for sports medicine surgeons

BACKGROUND

When choosing physicians, patients often review options online via physician review websites, which may influence decisions on providers.

PURPOSE

The purpose of this study is to investigate the impacts of social media usage, age, and patient reported wait times on online ratings for three popular review websites.

STUDY DESIGN

Cross-sectional study.

METHODS

The American Orthopaedic Society for Sports Medicine database was used to extract demographic information for all listed sports medicine surgeons in Florida. Overall ratings, number of ratings and comments, and patient reported wait-times were recorded from three leading review websites (Healthgrades.com, Vitals.com, Google.com). Professionally focused SM accounts were searched for each physician on Facebook.com, Twitter.com, Instagram, and LinkedIn.com.

RESULTS

102 orthopaedic sports medicine surgeons were included. At least one form of social media was used by 62.4% of our cohort. Those with social media had higher overall online physician ratings out of 5.00 across all review websites (Google:4.65vs4.44, p = 0.05; Healthgrades:4.41vs4.15, p = 0.03; Vitals:4.43vs4.14, p = 0.01). In bivariate analysis, older age was associated with lower ratings on Health Grades (Absolute difference (AD) -0.26, p < 0.0001), and social media was linked to higher ratings (Google: AD 0.21, p = 0.05; Healthgrades: AD 0.26, p = 0.03; Vitals: AD 0.29, p = 0.008). Longer wait times were associated with lower ratings in a dose-dependent manner in both bivariate and multivariable analysis.

CONCLUSIONS

Social media use among sports medicine surgeons correlated with higher overall physician ratings. Potentially, younger surgeons increase social media use because of a heightened concern for online image, whereas older surgeons may have less value in using online platforms to capitalize on an online presence. Older age and increased patient reported wait times in office had a negative correlation with online reviews, which highlights that factors beyond the surgeon's skill sets can influence overall ratings.

Evaluating Social Media Use Among Active American Members of the Cervical Spine Research Society

STUDY DESIGN

Observational study.

OBJECTIVES

The objectives of this study are (1) to quantify social media use among active American Cervical Spine Research Society (CSRS) members; (2) to determine if there is an association between practice setting, region, or years of active membership and social media use.

SUMMARY OF BACKGROUND DATA

Many patients now seek health and physician information online, including on social media. Indeed, social media use by orthopedic surgeons has been shown to be associated with more and improved ratings on physician review websites. Further, social media can provide a means for improved doctor-patient relationships, educational endeavors, and professional networking. However, there is a paucity of literature examining social media use among spine surgeons.

MATERIALS AND METHODS

In January 2019, the CSRS membership directory was used to identify all active American spine surgeon members. Through a Google search, social media use of each spine surgeon on the following platforms was identified: provider page/official website; Facebook; Twitter; Instagram; LinkedIn; and YouTube. In addition, surgeon characteristics were recorded. The percentage of spine surgeons using each social media platform was reported. Bivariate analysis was used to compare social media use by practice setting, region, and years of active CSRS membership.

RESULTS

Nearly all spine surgeons have a provider page/official website (98%) and over half (56%) have a LinkedIn presence. Less than one third of spine surgeons are on any of the remaining social media platforms analyzed. The least frequently used social media platform was Instagram (3.2%). There was no difference in any social media platform use by practice setting, region, and years of active CSRS membership.

CONCLUSIONS

As social media becomes even more common place and the role of it in medical care continues to be better defined, there is notable room for increased social media use among active American members of the CSRS.

LEVEL OF EVIDENCE

Level IV-observational study.

Online Ratings for Vascular Interventional Proceduralists Vary by Physician Specialty

BACKGROUND

Multiple specialties offer vascular interventional care, creating potential competition for referrals and procedures. At the same time, patient/consumer ratings have become more impactful for physicians who perform vascular procedures. We hypothesized that there are differences in online ratings based on specialty.

METHODS

We used official program lists from the Association for Graduate Medical Education to identify institutions with training programs in integrated vascular surgery (VS), integrated interventional radiology (IR), and interventional cardiology (IC). Faculty providers were identified in each specialty at these institutions. A standardized search was performed to collect online ratings from Vitals.com, Healthgrades.com, and Google.com as well as from online demographics. Between specialty differences were analyzed using chi-squared and analysis of variance tests as appropriate. Multivariable linear regression was used to identify factors associated with review volume and star rating.

RESULTS

A total of 1,330 providers (n = 454 VS, n = 451 IR, n = 425 IC) were identified across 47 institutions in 27 states. VS (55.5%-69.4%) and IC (63.8%-71.1%) providers were significantly more likely to have reviews than IR (28.6%-48.8%) providers across all online platforms (P < 0.001 for all websites). Across all platforms, IC providers were rated significantly higher than VS and IR providers. Multivariable regression showed that provider specialty and additional time in practice were associated with higher review volume. In addition to specialty, review volume was associated with star rating as those physicians with more reviews tended to have a higher rating.

CONCLUSIONS

On average, vascular surgeons have more reviews and are more highly rated than interventional radiologists but tend to have fewer reviews and lower ratings than interventional cardiologists. VS providers may benefit from encouraging patients to file online reviews, especially in competitive markets.

What Do Patients Say About Doctors Online? A Systematic Review of Studies on Patient Online Reviews

Background

The number of patient online reviews (PORs) has grown significantly, and PORs have played an increasingly important role in patients’ choice of health care providers.

Objective

The objective of our study was to systematically review studies on PORs, summarize the major findings and study characteristics, identify literature gaps, and make recommendations for future research.

Methods

A major database search was completed in January 2019. Studies were included if they (1) focused on PORs of physicians and hospitals, (2) reported qualitative or quantitative results from analysis of PORs, and (3) peer-reviewed empirical studies. Study characteristics and major findings were synthesized using predesigned tables.

Results

A total of 63 studies (69 articles) that met the above criteria were included in the review. Most studies (n=48) were conducted in the United States, including Puerto Rico, and the remaining were from Europe, Australia, and China. Earlier studies (published before 2010) used content analysis with small sample sizes; more recent studies retrieved and analyzed larger datasets using machine learning technologies. The number of PORs ranged from fewer than 200 to over 700,000. About 90% of the studies were focused on clinicians, typically specialists such as surgeons; 27% covered health care organizations, typically hospitals; and some studied both. A majority of PORs were positive and patients’ comments on their providers were favorable. Although most studies were descriptive, some compared PORs with traditional surveys of patient experience and found a high degree of correlation and some compared PORs with clinical outcomes but found a low level of correlation.

Conclusions

PORs contain valuable information that can generate insights into quality of care and patient-provider relationship, but it has not been systematically used for studies of health care quality. With the advancement of machine learning and data analysis tools, we anticipate more research on PORs based on testable hypotheses and rigorous analytic methods.

Trial Registration

International Prospective Register of Systematic Reviews (PROSPERO) CRD42018085057; https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=85057 (Archived by WebCite at http://www.webcitation.org/76ddvTZ1C)