Wednesday, September 26, 2018 2:00 PM – 3:00 PM Integrating Technology into Practice: 57. The impact of online physician rating websites on orthopedic clinical practice

Abstract

BACKGROUND CONTEXT Online physician and provider rating websites (OPRWs) are a commonly used resource for patients who seek a new physician. In 2010, nearly 40% of Americans utilized OPRWs prior to a new clinical visit. Prior studies have evaluated the manner and trends by which patients rate their physicians and providers. However, little is known as to how OPRWs affect the clinician and his or her practice. PURPOSE The purpose of this survey is to evaluate the impact of online physician and provider rating websites on the course of patient care as perceived by orthopedic surgeons and affiliated care providers. STUDY DESIGN/SETTING This is a cross-sectional survey of orthopedic providers. PATIENT SAMPLE A total of 234 local orthopedic surgeons, physiatrists, and physician assistants. OUTCOME MEASURES The frequency of orthopedic surgeons who deviate from their standard practice to elicit a positive patient review. METHODS An electronic, 18-question survey was circulated to 234 local orthopedic surgeons, physiatrist, and physician assistants. Survey results were collected anonymously and statistical analysis was performed on the representative demographic data and categorical responses. Statisticians were blinded to the respondents. RESULTS A total of 92 completed surveys were collected. The median post-training practice duration was 12 (range=0-37) years. Eighty-nine percent stated they were aware of OPRWs, with 60% visiting OPRWs in the past year. Seventeen percent admit to deviating from their standard practice to elicit a positive review while 30% did so to avoid a negative online review. Examples include prescribing additional narcotics, setting arbitrary activity limitations, and ordering unnecessary studies such as an MRI. Only 30% of respondents believe that OPRWs are a valuable resource to help patients select a new physician, while 95% stated that OPRWs failed to fairly and adequately reflect their competency. CONCLUSIONS Orthopedic surgeons and associated providers surveyed in this study are aware of OPRWs and a majority have reviewed their ratings within the past year. An overwhelming majority of respondents indicated that OPRWs are a flawed patient resource, and about a third have attempted to influence their ratings by deviating from their standard practice. These findings suggest that OPRWS indirectly alter patient care in ways that may not be beneficial, have the potential to result in patient harm, and increase health-care costs. Further investigation on this topic is warranted. FDA DEVICE/DRUG STATUS This abstract does not discuss or include any applicable devices or drugs.