Characterizing clinical and nonclinical factors in extremely negative online reviews of orthopedic shoulder surgeons

Online physician review websites are being increasingly utilized by patients when choosing their surgeon. Although most reviews are positive, extremely negative reviews can significantly compromise a physician's online reputation. The purpose of this study was to analyze factors that contribute to negative reviews for orthopedic shoulder surgeons. One hundred orthopedic shoulder surgeons were randomly selected from the "find a doctor" tool on the American Shoulder and Elbow Surgeons website. A search was performed for all reviews listed under the selected surgeons on the following sources: Google Reviews, Healthgrades, Vitals, and Yelp. For each website, a surgeon's average rating, total number of reviews, and number of 1-star reviews was recorded. One-star reviews with comments were then reviewed to categorize the complaint(s), determine whether they referenced a clinical or nonclinical issue, and determine whether the complaint referenced a surgical or nonsurgical episode of care. Categorical variables were analyzed using a chi-square test. A total of 7,616 reviews were analyzed and 722 (9.5%) were identified as 1-star. After application or exclusion criteria, 329 single-star reviews with 837 total complaints were included for analysis. Of the 329 single-star reviews, 237 (72.0%) were from nonsurgical patients and 92 (28.0%) were from surgically treated patients. Nonsurgical patients had a significantly higher rate of total complaints per each review than surgical patients (1.76 vs. 0.78, P = .034). The most common complaints were regarding bedside manner (160 complaints), insufficient time with the provider (82 complaints), uncontrolled pain (73 complaints), and rude staff (72 complaints). Poor surgical outcomes were noted in terms of complication (66 complaints), reoperation (26 complaints), and readmissions (2 complaints). For orthopedic shoulder surgeons, the most common complaints are nonclinical and include poor bedside manner, wait time, and insufficient time with the provider. Relatively few negative reviews referenced objective measures of health care quality such as complications or surgical outcomes. These results provide a deeper understanding of the reasons for patient dissatisfaction in shoulder surgery, which can be considered when striving to maintain a favorable online reputation.