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The internet has become a popular platform for patients to obtain information and to review the health care providers they interact with. However, little is known about the digital footprint of vascular surgeons and their interactions with patients on social media.
This study aims to understand the activity of academic vascular surgeons on physician rating websites.
Information on attending vascular surgeons affiliated with vascular residency or with fellowships in the Southern Association for Vascular Surgery (SAVS) was collected from public sources. A listing of websites containing physician ratings was obtained via literature reviews and Google search. Open access websites with either qualitative or quantitative evaluations of vascular surgeons were included. Closed access websites were excluded. Ranking scores from each website were converted to a standard 5-point scale for comparison.
A total of 6238 quantitative and 967 qualitative reviews were written for 287 physicians (236 males, 82.2%) across 16 websites that met the inclusion criteria out of the 62 websites screened. The surgeons affiliated with the integrated vascular residency and vascular fellowship programs in SAVS had a median of 8 (IQR 7-10) profiles across 16 websites, with only 1 surgeon having no web presence in any of the websites. The median number of quantitative ratings for each physician was 17 (IQR 6-34, range 1-137) and the median number of narrative reviews was 3 (IQR 2-6, range 1-28). Vitals, WebMD, and Healthgrades were the only 3 websites where over a quarter of the physicians were rated, and those rated had more than 5 ratings on average. The median score for the quantitative reviews was 4.4 (IQR 4.0-4.9). Most narrative reviews (758/967, 78.4%) were positive, but 20.2% (195/967) were considered negative; only 1.4% (14/967) were considered equivocal. No statistical difference was found in the number of quantitative reviews or in the overall average score in the physician ratings between physicians with social media profiles and those without social media profiles (departmental social media profile: median 23 vs 15, respectively,
The representation of vascular surgeons on physician rating websites is varied, with the majority of the vascular surgeons represented only in half of the physician rating websites The number of quantitative and qualitative reviews for academic vascular surgeons is low. No vascular surgeon responded to any of the reviews. The activity of vascular surgeons in this area of social media is low and reflects only a small digital footprint that patients can reach and review.
Social media resources continue to be used by commercial and nonprofit organizations for social marketing because of the advantages of access to a large number of consumers, presence of transparency, the wide global reach, the ability to boost web page traffic, and the ability to promote the brand name [
Physician rating websites display valuable information for a consumer regarding a physician’s practice, including the physician’s area of expertise, office location, office hours, insurance accepted, in addition to quantitative and qualitative reviews from past consumers. Although surveys have indicated that the insurance accepted, referrals from primary care physicians, and reputation are important in the selection of physicians, 65% of the physician rating website users have been shown to choose a physician after viewing positive reviews on websites, and conversely, 52% of the physician rating website users have avoided providers owing to the negative reviews shown on the websites [
Although physician rating websites contain a broad range of physician-specific data, the physicians rated on these websites are not evenly distributed among medical specialties [
This is a cross-sectional study of publicly held data in search engines and websites accessed from a US internet service provider from September 2019 to November 2019. Websites containing physician ratings were obtained via literature reviews and Google search. This study examines data in the public domain and does not contain Health Insurance Portability and Accountability Act (HIPAA) information or interactions with individuals; thus, it is exempt from institutional review board approval or consent.
The current integrated vascular residency and vascular fellowship program lists were obtained from the Accreditation Council for Graduate Medical Education website. Attending vascular surgeons affiliated with each of these programs in the Southern Association for Vascular Surgery (SAVS) were collected [
Health care review websites obtain the physician list through public records from the National Provider Identifier Registry, medical boards, etc. General review websites allow users or business owners to add physicians or edit information, whereas health care review websites require changes to be made through the management team. Most websites allow physicians to claim their profile for free after they create an account and go through the prompted steps. These websites then allow physicians to manage their profiles, audit for accuracy, respond to reviews, and dispute reviews depending on the website. Some websites offer sponsored profiles to physicians for a fee to promote their practice.
Data collection was performed between August 2019 and September 2019. Physician search was performed on individual websites with physician first name/first initial, middle name/middle initial, last name, and location in various combinations and orders. Supplementary Google search was performed with “physician name, website domain name” to enhance the discovery of the physician’s profile. A similar strategy was used in finding physician or department profiles on social media websites such as Facebook, Twitter, and LinkedIn. Physician-specific information such as gender, age, educational background, training, and professional association was collected through their professional websites affiliated with their institutions and physician rating websites.
Most physician rating websites used a ranking score of 1-5 while Dr.Score and Healthcare reviews used a ranking score of 1-10; the scores of these 2 sites were converted to the standard 5-point scale (1-5) for comparison. Physician rating websites with more than 1000 quantitative reviews were used to examine correlation. The Kendall rank correlation coefficient was used to adjust for ties. USNews&World Report was excluded from this analysis because the ratings in this website were derived from over 100 unspecified web-based sources gathered by a private company and does not collect patient reviews or ratings directly. Descriptive data were presented as median (IQR). Kendall correlation coefficient was used to evaluate the correlation between continuous variables. Mann-Whitney
Sixteen out of 62 websites met the inclusion criteria (
Flow diagram for website inclusion.
Physician profiles across 16 physician rating websites (N=287).
Websites | Physicians with profile, n (%)a | Incomplete profiles, n (%)b | Inaccurate profiles, n (%)c |
WebMD | 271 (94.4) | 25 (9.6) | 27 (10.0) |
USNews&World Report | 271 (94.4) | 1 (0.4) | 11 (4.1) |
Caredash | 266 (92.7) | 7 (2.6) | 21 (7.9) |
Vitals | 264 (92.0) | 3 (1.1) | 19 (7.2) |
Healthgrades | 264 (92.0) | 24 (9.1) | 44 (16.7) |
YP.com | 209 (72.8) | 86 (41.1) | 23 (11.0) |
RateMD | 199 (69.3) | 156 (78.4) | 50 (25.1) |
Dr.Score | 147 (51.2) | 46 (31.3) | 28 (19.0) |
Insiderpages | 101 (35.2) | 101 (100.0) | 0 (0.0) |
Local | 90 (31.4) | 87 (96.7) | 0 (0.0) |
Zocdoc | 79 (27.5) | 11 (13.9) | 4 (5.1) |
Yellowbook | 74 (25.8) | 72 (97.3) | 0 (0.0) |
Healthcare reviews | 70 (24.4) | 22 (31.4) | 0 (0.0) |
Wellness | 62 (21.6) | 26 (41.9) | 17 (27.4) |
Yelp | 53 (18.5) | 53 (100.0) | 10 (18.9) |
Yellowbot | 48 (16.7) | 46 (95.8) | 0 (0.0) |
aTotal number of physicians with profiles on the 16 websites=286.
bProfiles (n=766) with less than 50% of the required information (eg, training, expertise) or profiles that lack any physician-specific information besides practice location and office contact information. Percentage was calculated as the number of physicians with incomplete profiles by the total number of physicians with profiles for each website.
cProfiles with any inaccuracy in physician practice and demographic information (n=252). Percentage was calculated as the number of physicians with inaccurate profiles by the total number of physicians with profiles for each website.
Search strategy on the 4 most common physician rating websites (N=287).
Website name | Name search | Location search | Required search on Google, n (%) |
Vital | Must use middle initial, does not have full middle name in the system. If first name in the system is also initial only, entering full name will not find the physician. | Has a certain degree of matching by name during the search regardless of the correct location. | 0 (0.0) |
Healthgrades | Name must have the exact match being “first name, last name” in order to find through search. However, will provide matching in the search box without such restriction. | Has a certain degree of matching by name in the search box regardless of the correct location. | 7 (2.4) |
WebMD | Good name match. No requirement for the order of the name or differentiation between initial versus expanded name. | Location needs to be correct. Very low degree of matching by name only. | 18 (6.3) |
USNews&World Report | Must have correct expanded first name and last name. Order of the name and the middle name does not affect search. | Match of name is sufficient, correct location not required. | 1 (0.3) |
One potential confounding factor in individual physician profiles is the corresponding activity of the divisional profile digital footprint. Nine (9/37, 24%) vascular surgery divisions had social media profiles: 7 had only Twitter accounts, 1 had only Facebook profiles, and 1 had both Twitter and Facebook profiles. Physicians in the institutions with established departmental social media websites had a higher number of ratings compared to those without established departmental social media websites (median 23 [IQR 5-38] vs 15 [IQR 7-33], respectively,
Surgeons affiliated with the integrated vascular residency and vascular fellowship program of SAVS had a median (IQR) of 8 (7-10) profiles across 16 websites with only 1 surgeon having no web presence on any of the sites. Most physician profiles (2214/2466, 89.8%) were accurate, reflecting correct demographic affiliations and practice information (
A total of 6238 ratings and 967 narrative reviews were written for 287 physicians (236 males, 82.2%) affiliated with the integrated vascular residency and vascular fellowship program within the SAVS across the 16 websites surveyed (
Physician rating scores across 16 physician rating websites (N=287).
Websites | Physicians with rating, n (%)a | Total quantitative ratings (n=6238), n | Median score | IQR |
Vitals | 217 (75.7) | 1731 | 4.4 | 4-5 |
WebMD | 200 (69.7) | 1737 | 4.5 | 4-5 |
Healthgrades | 193 (67.2) | 1193 | 4.6 | 3.7-5 |
USNews&World Report | 71 (24.7) | 1296 | 5 | 4-5 |
RateMD | 46 (16.0) | 103 | 4 | 3-5 |
Dr.Score | 24 (8.3) | 34 | 5 | 4-5 |
Caredash | 18 (6.3) | 22 | 5 | 5-5 |
Wellness | 11 (3.8) | 20 | 4.5 | 3.8-5 |
Yellowbot | 7 (2.4) | 17 | 5 | 5-5 |
Zocdoc | 7 (2.4) | 65 | 5 | 4-5 |
Insiderpages | 6 (2.1) | 13 | 5 | 4.3-5 |
YP.com | 4 (1.4) | 4 | 5 | 4-5 |
Yelp | 2 (0.7) | 2 | 3 | 2-4 |
Healthcare reviews | 1 (0.3) | 1 | 5 | N/Ab |
Local | 0 (0.0) | 0 | N/A | N/A |
Yellowbook | 0 (0.0) | 0 | N/A | N/A |
aTotal number of physicians with at least 1 rating=251.
bN/A: not applicable.
Narrative reviews across 16 physician rating websites.
Websites | Physicians with narrative reviews (n=287), n (%)a | Total narrative reviews (n=967), n | Positive narrative reviews, n (%)b,c | Neutral narrative reviews, n (%)c,d | Negative narrative reviews, n (%)c,e | Patient found useful (n=737), n | Patient found not useful (n=150), n |
Vitals | 151 (52.6) | 482 | 374 (77.6) | 5 (1.0) | 103 (21.4) | 0 | 0 |
WebMD | 1 (0.3) | 1 | 1 (100.0) | 0 (0.0) | 0 (0.0) | 0 | 0 |
Healthgrades | 136 (47.4) | 308 | 248 (80.5) | 0 (0.0) | 60 (19.5) | 704 | 148 |
USNews&World Report | 0 (0.0) | 0 | 0 (0.0) | 0 (0.0) | 0 (0.0) | 0 | 0 |
RateMD | 43 (15) | 88 | 58 (65.9) | 5 (5.7) | 25 (28.4) | 29 | 0 |
Dr.Score | 0 (0.0) | 0 | 0 (0.0) | 0 (0.0) | 0 (0.0) | 0 | 0 |
Caredash | 14 (4.9) | 16 | 15 (93.8) | 1 (6.3) | 0 (0.0) | 4 | 2 |
Wellness | 8 (2.8) | 17 | 15 (88.2) | 0 (0.0) | 2 (11.8) | 0 | 0 |
Yellowbot | 7 (2.4) | 19 | 19 (100.0) | 0 (0.0) | 0 (0.0) | 0 | 0 |
Zocdoc | 6 (2.1) | 29 | 23 (79.3) | 3 (10.3) | 3 (0.3) | 0 | 0 |
Insiderpages | 1 (0.3) | 1 | 1 (100.0) | 0 (0.0) | 0 (0.0) | 0 | 0 |
YP.com | 4 (1.4) | 4 | 3 (75.0) | 0 (0.0) | 1 (25.0) | 0 | 0 |
Yelp | 2 (0.7) | 2 | 1 (50.0) | 0 (0.0) | 1 (50.0) | 0 | 0 |
Health care reviews | 0 (0.0) | 0 | 0 (0.0) | 0 (0.0) | 0 (0.0) | 0 | 0 |
Local | 0 (0.0) | 0 | 0 (0.0) | 0 (0.0) | 0 (0.0) | 0 | 0 |
Yellowbook | 0 (0.0) | 0 | 0 (0.0) | 0 (0.0) | 0 (0.0) | 0 | 0 |
a197 physicians received narrative reviews.
bTotal number of positive narrative interviews=758.
cThe percentages for the positive, neutral, and negative narrative review columns were calculated over the total narrative reviews in the 3rd column.
dTotal number of neutral narrative interviews=14.
eTotal number of negative narrative interviews=195.
The physician scores on Vitals and WebMD correlated well (Kendall τ=0.78,
The social media profiles of vascular surgeons (especially LinkedIn) and the rating number followed a similar curve with small peaks in the age groups of 20-24 years and 35-39 years (
Total number of ratings across 16 physician rating websites by years of experience (number of years after graduation from allopathic or osteopathic school). The lower, middle, and upper hinges of the box represent 25th percentile, 50th percentile or median, and 75th percentile, respectively. Whiskers represent 1.5 interquartile range, and points represent outliers.
Proportion of physicians with profiles on 3 different social media platforms among physicians with different years of experience by the number of years after graduation from an allopathic or osteopathic school.
Of the 2 physician rating websites with a significant number of narrative reviews, Vitals did not provide reviewer names while a third (111/308, 36.0%) of the reviewers on Healthgrades provided their full name; another 29.5% (91/308) provided only the initial or the first name, while a third (106/308, 34.4%) remained completely anonymous.
Our study found that the presence of academic vascular surgeons affiliated with the integrated vascular residency and vascular fellowship program within the SAVS was low on physician rating websites. Of the 287 physicians, 87.4% (251/287) of the physicians had at least one rating across 16 physician rating websites and 68.6% (197/287) had at least one narrative review. The density of the reviews was low, with a median of 17 for the quantitative ratings and a median of 3 for the narrative reviews for those who had at least 1 rating or narrative review across 16 physician rating websites. No physician responded to any of the reviews.
The study has a limited sample and may not be extrapolated to all US academic vascular physicians. We were unable to correlate physician ratings with USNews&World Report hospital rankings, urban or rural locations, and whether the academic center had a social media department because minimal variation existed in these variables. It was not possible to identify the type of procedure offered by the physicians to assess its effect on the patient reviews. We did not correlate hospitals’ own review systems with physician rating websites or Press Ganey scores. Additionally, information on the internet is dynamic; physicians could have accumulated additional reviews since the time of our data collection. Lastly, we did an extensive search to investigate the physician rating websites, and multiple searches were performed on individual providers to ensure that we captured maximum information. However, it is possible that there were websites or profiles that we may have missed or we may not have investigated. This likely does not significantly affect our study, as it would be equally difficult for patients to locate such websites or profiles and likely contain minimal information.
Direct comparisons between previous studies of physician rating websites is difficult due to differences in physician selection. There is a general trend of an increasing percentage of physicians rated over time. Vascular surgeons were significantly underrepresented compared to orthopedic surgeons; 94.3%-99.5% of the orthopedic surgeons were rated on physician rating websites with a much higher number of ratings—triple that of vascular surgeons in some instances, and we speculate that this difference may be attributed to differences in the specialties rather than differences in physician demographics [
In general, patients rated vascular surgeons very positively, with the median score for almost all the websites being 4 or higher on a 5-point scale, and 78.4% (758/967) of the comments were positive overall. This is consistent with prior findings regardless of specialty [
In our study, we did not find any physician demographic characteristics, level of social media presence, or total rating frequency that contributed to the overall rating scores. Some studies found that younger physicians received higher scores, which could be attributed to the better relationships between younger patients and younger physicians, thereby leading to increased number of reviews with high scores [
Higher numbers of physician rating website profiles were seen for vascular surgeons with social media profiles, whether personal or departmental, but there was no statistical significance. Physicians with <14 or >40 years of experience were less likely to be rated. Small peaks were noted in the 20-24 years and 35-39 years of experience groups. This could be related to the similar trend seen in social media profiles. Gao et al also found that less experienced physicians had fewer ratings because they are still developing their practice and reputation [
The inconsistency in the physician ratings between physician rating websites and variable findings in factors predictive of better ratings is likely due to the low density of the ratings, leading to high susceptibility to outliers. Healthgrades, Vitals, WebMD, USNews&World Report, and Zocdoc were the only sites wherein the average number of ratings exceeded 5 for those rated. Vitals, WebMD, and Healthgrades were the only 3 websites, wherein over a quarter of the physicians were rated. These may be the better websites for vascular surgeons to focus on in a social media campaign. The large number of physician rating websites and directories—33 in 2010 and 28 in 2018—dilutes patient reviews [
Responding to a review is an important customer relationship exercise. No physician responded to any qualitative review in our study, including the 193 negative narrative reviews. In a study of the German physician rating website called “
Limited physician responses may be related to fear of HIPAA violation and offering an asynchronous medical opinion. Revealing patient information on social media without patient consent undermines patient trust and can lead to legal and civil actions [
Narrative reviews on physician rating websites have the potential of expanding the scope of quality measurement for providers. A recent study of Yelp reviews on hospitals has shown that patient reviews not only covered 7 out of the 12 categories included in the Hospital Consumer Assessment of Healthcare Providers and Systems but also consisted of additional 12 categories (
The limitations of physician rating websites include varied quality, limited accountability, and limited representativeness. In a global study on physician rating websites, the United States had a large number of physician rating websites but more considerable variation in the quality compared to European physician rating websites [
Social media platforms have been used to advertise practice and attract referrals with relatively high returns on investment [
Cost of hospital visit
Insurance billing
Ancillary testing
Facilities
Amenities
Scheduling
Compassion of staff
Family member care
Quality of nursing
Quality of staff
Quality of technical aspects of care
Specific type of medical care
The representation of vascular surgeons on physician rating websites is varied, with the majority of the vascular surgeons represented only in half of the physician rating websites. The number of quantitative and qualitative reviews for vascular surgeons is low; therefore, no surgeon responded to any of the reviews. The activity of the vascular surgeons in this area of social media is low and reflects a small digital footprint that patients can reach and review. Healthgrades, Vitals, and WebMD are the most recommended physician rating platforms for vascular surgeons to focus on to promote and improve their practice.
Definitions of physician profiles.
List of physician rating websites included in our study.
Health Insurance Portability and Accountability Act
Southern Association for Vascular Surgery
None declared.