Abstract
BackgroundThe majority of physician rating websites (PRWs) provide users the option to leave narrative comments about their physicians. Narrative comments potentially provide richer insights into patients’ experiences and feelings that cannot be fully captured in predefined quantitative rating scales and are increasingly being examined. However, the content and nature of narrative comments on Swiss PRWs has not been examined to date.ObjectiveThis study aimed to examine (1) the types of issues raised in narrative comments on Swiss PRWs and (2) the evaluation tendencies of the narrative comments.MethodsA random stratified sample of 966 physicians was generated from the regions of Zürich and Geneva. Every selected physician was searched for on 3 PRWs (OkDoc, DocApp, and Medicosearch) and Google, and narrative comments were collected. Narrative comments were analyzed and classified according to a theoretical categorization framework of physician-, staff-, and practice-related issues.ResultsThe selected physicians had a total of 849 comments. In total, 43 subcategories addressing the physician (n=21), staff (n=8), and practice (n=14) were identified. None of the PRWs’ comments covered all 43 subcategories of the categorization framework; comments on Google covered 86% (37/43) of the subcategories, Medicosearch covered 72% (31/43), DocApp covered 60% (26/43), and OkDoc covered 56% (24/43). In total, 2441 distinct issues were identified within the 43 subcategories of the categorization framework; 83.65% (2042/2441) of the issues related to the physician, 6.63% (162/2441) related to the staff, and 9.70% (237/2441) related to the practice. Overall, 95% (41/43) of the subcategories of the categorization framework and 81.60% (1992/2441) of the distinct issues identified were concerning aspects of performance (interpersonal skills of the physician and staff, infrastructure, and organization and management of the practice) that are considered assessable by patients. Overall, 83.0% (705/849) of comments were classified as positive, 2.5% (21/849) as neutral, and 14.5% (123/849) as negative. However, there were significant differences between PRWs, regions, and specialty regarding negative comments: 90.2% (111/123) of negative comments were on Google, 74.7% (92/123) were regarding physicians in Zurich, and 73.2% (90/123) were from specialists.ConclusionsFrom the narrative comments analyzed, it can be reported that interpersonal issues make up nearly half of all negative issues identified, and it is recommended that physicians should focus on improving these issues. The current suppression of negative comments by Swiss PRWs is concerning, and there is a need for a consensus-based criterion to be developed to determine which comments should be published publicly. Finally, it would be helpful if Swiss patients are made aware of the current large differences between Swiss PRWs regarding the frequency and nature of ratings to help them determine which PRW will provide them with the most useful information.
Highlights
Physician rating websites (PRWs) are a sign of the growing digitalization of the patient-health professional relationship, allowing patients to anonymously rate their physicians on the Web as a source of information for others [1,2,3,4,5,6,7,8]
There were significant differences between physician rating website (PRW), regions, and specialty regarding negative comments: 90.2% (111/123) of negative comments were on Google, 74.7% (92/123) were regarding physicians in Zurich, and 73.2% (90/123) were from specialists
From the narrative comments analyzed, it can be reported that interpersonal issues make up nearly half of all negative issues identified, and it is recommended that physicians should focus on improving these issues
Summary
Physician rating websites (PRWs) are a sign of the growing digitalization of the patient-health professional relationship, allowing patients to anonymously rate their physicians on the Web as a source of information for others [1,2,3,4,5,6,7,8]. Narrative comments potentially provide richer insights into patients’ experiences and feelings that cannot be fully captured in predefined quantitative rating scales and are increasingly being examined with content analysis [4,8,12,13,14,15], and more recently with machine learning [16,17]. Recent research suggests that patients acknowledge their inability to rate physicians’ technical competency [21], an analysis of 3000 narrative comments from the German PRW, jameda, from 2012 found that physicians’ competence was the most frequent issue that patients mentioned in their comments (1874/3000, 62.46%) [4] It is unclear whether this apparent contradiction, between patients’ agreement about their inability to evaluate physicians’ technical skills and their actual ratings, exists on other PRWs and countries, but the need for more research on this issue has been highlighted [21]. The content and nature of narrative comments on Swiss PRWs has not been examined to date
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