JMIR Publications

ABSTRACT

Background:

The 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 contents and nature of narrative comments on Swiss PRWs has not been examined to date.

Objective:

The aim of this study is to examine 1) the types of issues raised in narrative comments on Swiss PRWs, and 2) the evaluation tendencies of the narrative comments.

Methods:

A random stratified sample of 966 physicians was generated from the regions of Zürich and Geneva. Every selected physician was searched for on three PRWs (okdoc.ch, docapp.ch, and medicosearch.ch) and google.ch, and narrative comments collected. Narrative comments were analysed and classified according to a theoretical categorization framework of physician, staff, and practice related issues.

Results:

The selected physicians in the sample had a total of 849 comments. In total, 43 sub-categories addressing the physician (n=21), the staff (n=8), and the practice (n=14) were identified. None of the PRWs’ comments covered all 43 sub-categories of the categorization framework; comments on google covered 86% (37/43) of the sub-categories, medicosearch covered 72.1% (31/43), docapp covered 60.5% (26/43), and okdoc covered 55.8% (24/43). In total, 2441 distinct issues were identified within the 43 sub-categories of the categorization framework; 83.6% (2042/2441) of the issues related to the physician, 6.6% (162/2441) related to staff, and 9.7% (237/2441) related to the practice. Overall, 95.3% (41/43) of the sub-categories of the categorization framework and 81.6% (1992/2441) of the distinct issues identified were concerning aspects of performance (interpersonal skills of physician and staff, infrastructure, organisation and management of practice) that are considered assessable by patients. Overall, 83% (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 speciality 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.

Conclusions:

Interpersonal issues make up nearly half of all negative issues reported the narrative comments analysed 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 criteria to be developed to determine which comments should be publically published. 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. Clinical Trial: N/A