Brinkman et al. [1] identified and characterized negative Yelp.com reviews of orthopedic spine surgeons and practices in eight major US metropolitan areas. This is a timely and important topic, as reviews such as these continue to increase in number and may play a significant role in how patients choose their physicians.Yelp.com was selected for this study, as it was noted to be the most frequently utilized online resource by patients. Reviews were identified using the keywords “orthopedic spine surgery” and drawn from eight large US metropolitan areas. From there, one-star reviews were identified and analyzed as the subject of the study. These reviews were classified as clinical or nonclinical (depending on whether they referenced the quality of medical care) and surgical or nonsurgical (depending on whether surgery was explicitly referenced).In total, 6286 reviews were identified, of which one-star rating were noted for 671 (10.6%). Of the reviews identified, 374 were excluded due to an inability to classify them or unclear rations to spine surgery and 297 reviews were included for further analysis.Several themes were identified in the content of the one-star reviews. The majority of reviews were related to nonclinical complaints (77.6%). Further, the majority of the reviews were written by nonsurgical patients (76.4%). The most cited clinical complaints related to complications (16% of reviews), uncontrolled pain (12%), or perceived misdiagnosis (6%). The most cited nonclinical complaints related to bedside manner (49%), rude or unprofessional misconduct (31%), and wait time (25%).The current study is discussed in the context of previous studies showing that crowd-sourced physician ratings often do not align with traditional healthcare quality metrics. By focusing on one-star reviews, the study highlights the most negative reviews, analogous to how other quality metrics are often interpreted with a focus on the most positive reviews.By delineating the areas that are focused on by the most negative review, the discussed study sheds light on areas that physicians, practices, and healthcare systems should consider as foremost on patients’ minds. Especially noting the predominance of non-clinical issues raised by these reviews, the importance of addressing all aspects of patient care is underscored.A clear limitation of the current study is that the analyses were based on a select set of reviews. The reviews were all from Yelp.com, which might draw a different set of reviewers than other websites or social media platforms. Similarly, the study focused on a group of large metropolitan areas for the reviews, while feedback might differ in other areas.There is also the consideration that only the most negative reviews were studied. Future research analyzing the content of the most positive online reviews might set clearer goals of what patients, the “healthcare consumers,” are looking for when choosing a spine surgeon.Despite some limitations, the study provides a clear message. The most negative reviews of spine surgeons on platforms such as Yelp.com often come from nonsurgical patients and focus on nonclinical concerns. As patients are clearly using these platforms to guide where they seek medical care, such metrics should guide areas for quality improvement with regards to patient expectations and experience.
Financial disclosures/conflicts of interests
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