248. Characterizing negative reviews of orthopedic spine surgery practices and surgeons on Yelp.com

BACKGROUND CONTEXT Recent evidence suggests that patients prefer subjective and crowd-sourced information over data-driven or quality-based outcomes when choosing a surgeon. Online physician rating and review websites continue to increase in popularity, and over half of patients use them to research physicians. Yelp.com is the most frequently utilized online resource by patients. Data regarding the characteristics of negative reviews for spine surgeons is lacking. PURPOSE To describe and characterize negative reviews of orthopedic spine surgeons and practices on Yelp.com. STUDY DESIGN/SETTING Descriptive study. OUTCOME MEASURES Overall rate of one-star reviews nonsurgical versus surgical episode of care associated with the review nonclinical versus clinical factors noted in the review, classification of review factors (wait time, bedside manner, complication, pain, etc.). METHODS Reviews for orthopedic spine surgeons and practices in 8 major US metropolitan regions were surveyed. One-star reviews were analyzed and classified according to the clinical or nonclinical nature of the complaint. Reviews were also subclassified into nonsurgical or surgical episodes of care. RESULTS A total of 6,286 Yelp reviews were discovered, 671 (10.6%) of which were rated one-star. The majority of negative reviews (76.4%) were from patients who did not report surgery by the surgeon or practice. Of all one-star comments, 491 (77.6%) were related to nonclinical complaints. The most common factors noted in negative reviews were related to bedside manner, rude or unprofessional staff, and wait time. Surgical complications (16%) and need for reoperation (3%) were noted in a minority of reviews. CONCLUSIONS In our series, the large majority of negative reviews were related to nonclinical issues such as poor bedside manner or rude staff and most of these were written by patients that did not undergo a surgical procedure. This may explain the large discrepancy that has been observed between quality metrics and online crowd-sourced reviews. Paying attention to these nonclinical factors may represent the most feasible and valuable targets to improve a surgeon's practice and attract future patients. FDA DEVICE/DRUG STATUS This abstract does not discuss or include any applicable devices or drugs.