Characterizing Negative Online Reviews of Spine Surgeons.

DESIGN: Retrospective review.

OBJECTIVE: Characterize negative reviews of spine surgeons in the United States.

SUMMARY: Physician rating websites significantly influence the selection of doctors by other patients. Negative experiences are impacted by various factors, both clinical and nonclinical, geography, and practice structure. The purpose of this study was to evaluate and categorize negative reviews of spine surgeons in the United States, with a focus on surgical versus nonsurgical reviewers.

METHODS: Spine surgeons were selected from available online professional society membership directories. A search for reviews was performed on Healthgrades.com, Vitals.com, and RateMDs.com for the past 10 years. Free response reviews were coded by complaint and qualitative analysis was performed. Chi-square and Fisher exact tests were used to compare categorical variables, and multiple comparisons were adjusted with Benjamini-Hochberg correction. A binary logistic regression model was performed for the top three most mentioned nonclinical and clinical complaint labels. A P-value<0.05 was considered statistically significant.

RESULTS: A total of 16,695 online reviews were evaluated, including 1690 one-star reviews (10.1%). Amongst one-star reviews, 64.7% were written by nonsurgical patients and 35.3% by surgical patients. Nonclinical and clinical comments constituted 54.9% and 45.1% of reviews, respectively Surgeons in the South had more "bedside manner" comments (43.3%, P<0.0001), while Northeast surgeons had more "poor surgical outcome" remarks compared to all other geographic regions (14.4%, P<0.001). Practicing in the South and Northeast were independent predictors of having complaints about "bedside manner" and "poor surgical outcome", respectively.

CONCLUSION: Most one-star reviews of spine surgeons were attributed to nonsurgical patients, who tended to be unsatisfied with nonclinical factors, especially "bedside manner". However, there was substantial geographic variation. These results suggest that spine surgeons could benefit from focusing on nonclinical factors (bedside manner), especially amongst nonoperative patients, and that regional nuances should be considered in delivering spine care.

LEVEL OF EVIDENCE: Level 5.