scholarly journals Quantitative Ratings and Narrative Comments on Swiss Physician Rating Websites: Frequency Analysis (Preprint)

2019 ◽  
Author(s):  
Stuart McLennan
Keyword(s):  
Health Care Quality ◽  
Rating Scale ◽  
Care Quality ◽  
The Past ◽  
Reliable Source ◽  
Stratified Sample ◽  
Physician Rating ◽  
Quantitative Rating ◽  
First Time ◽  
Narrative Comments

BACKGROUND Physician rating websites (PRWs) have been developed as part of a wider move toward transparency around health care quality, and these allow patients to anonymously rate, comment, and discuss physicians’ quality on the Web. The first Swiss PRWs were established in 2008, at the same time as many international PRWs. However, there has been limited research conducted on PRWs in Switzerland to date. International research has indicated that a key shortcoming of PRWs is that they have an insufficient number of ratings. OBJECTIVE The aim of this study was to examine the frequency of quantitative ratings and narrative comments on the Swiss PRWs. METHODS In November 2017, a random stratified sample of 966 physicians was generated from the regions of Zürich and Geneva. Every selected physician was searched for on 4 rating websites (OkDoc, DocApp, Medicosearch, and Google) between November 2017 and July 2018. It was recorded whether the physician could be identified, what the physician’s quantitative rating was, and whether the physician had received narrative comments. In addition, Alexa Internet was used to examine the number of visitors to the PRWs, compared with other websites. RESULTS Overall, the portion of physicians able to be identified on the PRWs ranged from 42.4% (410/966) on OkDoc to 87.3% (843/966) on DocApp. Of the identifiable physicians, only a few of the selected physicians had been rated quantitatively (4.5% [38/843] on DocApp to 49.8% [273/548] on Google) or received narrative comments (4.5% [38/843] on DocApp to 31.2% [171/548] on Google) at least once. Rated physicians also had, on average, a low number of quantitative ratings (1.47 ratings on OkDoc to 3.74 rating on Google) and narrative comments (1.23 comment on OkDoc to 3.03 comments on Google). All 3 websites allowing ratings used the same rating scale (1-5 stars) and had a very positive average rating: DocApp (4.71), Medicosearch (4.69), and Google (4.41). There were significant differences among the PRWs (with the majority of ratings being posted on Google in past 2 years) and regions (with physicians in Zurich more likely to have been rated and have more ratings on average). Only Google (position 1) and Medicosearch (position 8358) are placed among the top 10,000 visited websites in Switzerland. CONCLUSIONS It appears that this is the first time Google has been included in a study examining physician ratings internationally and it is noticeable how Google has had substantially more ratings than the 3 dedicated PRWs in Switzerland over the past 2 and a half years. Overall, this study indicates that Swiss PRWs are not yet a reliable source of unbiased information regarding patient experiences and satisfaction with Swiss physicians; many selected physicians were unable to be identified, only a few physicians had been rated, and the ratings posted were overwhelmingly positive.

scholarly journals The Content and Nature of Narrative Comments on Swiss Physician Rating Websites: Analysis of 849 Comments

10.2196/14336 ◽  
2019 ◽  
Vol 21 (9) ◽  
pp. e14336 ◽  
Author(s):  
Stuart McLennan
Keyword(s):  
Interpersonal Skills ◽  
Rating Scales ◽  
Organization And Management ◽  
Negative Comments ◽  
Stratified Sample ◽  
Physician Rating ◽  
Quantitative Rating ◽  
Narrative Comments

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 content and nature of narrative comments on Swiss PRWs has not been examined to date. Objective This study aimed 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 3 PRWs (OkDoc, DocApp, and Medicosearch) and Google, and narrative comments were collected. Narrative comments were analyzed and classified according to a theoretical categorization framework of physician-, staff-, and practice-related issues. Results The selected physicians had a total of 849 comments. In total, 43 subcategories addressing the physician (n=21), staff (n=8), and practice (n=14) were identified. None of the PRWs’ comments covered all 43 subcategories of the categorization framework; comments on Google covered 86% (37/43) of the subcategories, Medicosearch covered 72% (31/43), DocApp covered 60% (26/43), and OkDoc covered 56% (24/43). In total, 2441 distinct issues were identified within the 43 subcategories of the categorization framework; 83.65% (2042/2441) of the issues related to the physician, 6.63% (162/2441) related to the staff, and 9.70% (237/2441) related to the practice. Overall, 95% (41/43) of the subcategories of the categorization framework and 81.60% (1992/2441) of the distinct issues identified were concerning aspects of performance (interpersonal skills of the physician and staff, infrastructure, and organization and management of the practice) that are considered assessable by patients. Overall, 83.0% (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 specialty 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 From the narrative comments analyzed, it can be reported that interpersonal issues make up nearly half of all negative issues identified, 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 criterion to be developed to determine which comments should be published publicly. 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.

scholarly journals The Content and Nature of Narrative Comments on Swiss Physician Rating Websites: Analysis of 849 Comments (Preprint)

2019 ◽  
Author(s):  
Stuart McLennan
Keyword(s):  
Interpersonal Skills ◽  
Rating Scales ◽  
Organization And Management ◽  
Negative Comments ◽  
Stratified Sample ◽  
Physician Rating ◽  
Quantitative Rating ◽  
Narrative Comments

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 content and nature of narrative comments on Swiss PRWs has not been examined to date. OBJECTIVE This study aimed 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 3 PRWs (OkDoc, DocApp, and Medicosearch) and Google, and narrative comments were collected. Narrative comments were analyzed and classified according to a theoretical categorization framework of physician-, staff-, and practice-related issues. RESULTS The selected physicians had a total of 849 comments. In total, 43 subcategories addressing the physician (n=21), staff (n=8), and practice (n=14) were identified. None of the PRWs’ comments covered all 43 subcategories of the categorization framework; comments on Google covered 86% (37/43) of the subcategories, Medicosearch covered 72% (31/43), DocApp covered 60% (26/43), and OkDoc covered 56% (24/43). In total, 2441 distinct issues were identified within the 43 subcategories of the categorization framework; 83.65% (2042/2441) of the issues related to the physician, 6.63% (162/2441) related to the staff, and 9.70% (237/2441) related to the practice. Overall, 95% (41/43) of the subcategories of the categorization framework and 81.60% (1992/2441) of the distinct issues identified were concerning aspects of performance (interpersonal skills of the physician and staff, infrastructure, and organization and management of the practice) that are considered assessable by patients. Overall, 83.0% (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 specialty 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 From the narrative comments analyzed, it can be reported that interpersonal issues make up nearly half of all negative issues identified, 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 criterion to be developed to determine which comments should be published publicly. 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.

scholarly journals Hearing Loss and Help-Seeking Behavior

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 797-797
Author(s):  
Nicholas Reed
Keyword(s):  
Health Care ◽  
Hearing Loss ◽  
Help Seeking ◽  
Health Care Quality ◽  
Medicare Beneficiary ◽  
Care Quality ◽  
The Past ◽  
Help Seeking Behaviour ◽  
Seeking Behavior ◽  
Future Work

Abstract Hearing Loss (HL) is common among older adults and is associated with poor health care quality outcomes include 30-day readmissions, length of stay, poorer satisfaction, and increased medical expenditures. These associations may manifest in changes in help-seeking behaviour. In the 2015 Current Medicare Beneficiary Study (MCBS) (n=10848; weighted sample=46.3 million), participants reported whether they knowingly had avoided seeking care in the past year and self-reported HL was measured as degree of trouble (none, a little, or a lot) hearing when using a hearing aid if applicable. In a model adjusted for demographic, socioeconomic, and health factors, those with a little trouble (OR= 1.612; 95% CI= 1.334-1.947; P<0.001) and a lot of trouble hearing (OR= 2.011; 95% CI= 1.443-2.801; P<0.001) had 61.2% and 101.1% higher odds of avoiding health care over the past year relative to participants with no trouble hearing. Future work should examine whether hearing care modifies this association.

scholarly journals Rejected Online Feedback From a Swiss Physician Rating Website Between 2008 and 2017: Analysis of 2352 Ratings (Preprint)

2020 ◽  
Author(s):  
Stuart McLennan
Keyword(s):  
Financial Incentives ◽  
German Language ◽  
Patient Feedback ◽  
Narrative Comment ◽  
Satisfaction With Treatment ◽  
Physician Rating ◽  
Quantitative Rating ◽  
Physician Rating Website ◽  
Online Feedback ◽  
Narrative Comments

BACKGROUND Previous research internationally has only analyzed publicly available feedback on physician rating websites (PRWs). However, it appears that many PRWs are not publishing all the feedback they receive. Analysis of this rejected feedback could provide a better understanding of the types of feedback that are currently not published and whether this is appropriate. OBJECTIVE The aim of this study was to examine (1) the number of patient feedback rejected from the Swiss PRW Medicosearch, (2) the evaluation tendencies of the rejected patient feedback, and (3) the types of issues raised in the rejected narrative comments. METHODS The Swiss PRW Medicosearch provided all the feedback that had been rejected between September 16, 2008, and September 22, 2017. The feedback were analyzed and classified according to a theoretical categorization framework of physician-, staff-, and practice-related issues. RESULTS Between September 16, 2008, and September 22, 2017, Medicosearch rejected a total of 2352 patient feedback. The majority of feedback rejected (1754/2352, 74.6%) had narrative comments in the German language. However, 11.9% (279/2352) of the rejected feedback only provided a quantitative rating with no narrative comment. Overall, 25% (588/2352) of the rejected feedback were positive, 18.7% (440/2352) were neutral, and 56% (1316/2352) were negative. The average rating of the rejected feedback was 2.8 (SD 1.4). In total, 44 subcategories addressing the physician (n=20), staff (n=9), and practice (n=15) were identified. In total, 3804 distinct issues were identified within the 44 subcategories of the categorization framework; 75% (2854/3804) of the issues were related to the physician, 6.4% (242/3804) were related to the staff, and 18.6% (708/3804) were related to the practice. Frequently mentioned issues identified from the rejected feedback included (1) satisfaction with treatment (533/1903, 28%); (2) the overall assessment of the physician (392/1903, 20.6%); (3) recommending the physician (345/1903, 18.1%); (4) the physician’s communication (261/1903, 13.7%); (5) the physician’s caring attitude (220/1903, 11.6%); and (6) the physician’s friendliness (203/1903, 10.6%). CONCLUSIONS It is unclear why the majority of the feedback were rejected. This is problematic and raises concerns that online patient feedback are being inappropriately manipulated. If online patient feedback is going to be collected, there needs to be clear policies and practices about how this is handled. It cannot be left to the whims of PRWs, who may have financial incentives to suppress negative feedback, to decide which feedback is or is not published online. Further research is needed to examine how many PRWs are using criteria for determining which feedback is published or not, what those criteria are, and what measures PRWs are using to address the manipulation of online patient feedback.

scholarly journals Theoretical and Methodological Contributions of Narrative Psychology to Ethnic Identity Research

2018 ◽  
Author(s):  
Moin Syed
Keyword(s):  
Ethnic Identity ◽  
Identity Development ◽  
Rating Scale ◽  
Ethnic Identity Development ◽  
Narrative Psychology ◽  
The Past ◽  
Methodological Tool ◽  
Quantitative Rating ◽  
Theoretical Issues

The purpose of this chapter is to showcase how narrative, or the stories that people tell about their experiences, is a useful theoretical and methodological tool for understanding ethnic identity development. Over the past two decades, research on ethnic identity development has primarily relied on quantitative, rating-scale instruments (Phinney, 1992; Sellers et al., 1998). While this methodology has contributed to a strong knowledge base regarding the correlates and developmental course of ethnic identity (Quintana, 2007), what has been lacking is an analysis of the lived experiences that constitute one’s ethnic identity and contribute to its development. To this end, the chapter includes a synthesis of published and ongoing studies to illustrate how a narrative approach can contribute to theoretical issues of major importance to the study of ethnic identity: how ethnic identity develops, the role of context in development, and the dimensionality of ethnic identity. These examples highlight the close connection between method and theory, as well as how narrative research can inform subsequent survey-based work.

scholarly journals Association Between Web-Based Physician Ratings and Physician Disciplinary Convictions: Retrospective Observational Study (Preprint)

2019 ◽  
Author(s):  
Jessica Janine Liu ◽  
Hanna R Goldberg ◽  
Eric JM Lentz ◽  
John Justin Matelski ◽  
Asim Alam ◽  
...  
Keyword(s):  
Observational Study ◽  
Health Care Quality ◽  
Quality Care ◽  
Sexual Misconduct ◽  
Poor Quality ◽  
Care Quality ◽  
Web Based ◽  
Sexual Offenses ◽  
Physician Rating ◽  
Physician Rating Website

BACKGROUND Physician rating websites are commonly used by the public, yet the relationship between web-based physician ratings and health care quality is not well understood. OBJECTIVE The objective of our study was to use physician disciplinary convictions as an extreme marker for poor physician quality and to investigate whether disciplined physicians have lower ratings than nondisciplined matched controls. METHODS This was a retrospective national observational study of all disciplined physicians in Canada (751 physicians, 2000 to 2013). We searched ratings (2005-2015) from the country’s leading online physician rating website for this group, and for 751 matched controls according to gender, specialty, practice years, and location. We compared overall ratings (out of a score of 5) as well as mean ratings by the type of misconduct. We also compared ratings for each type of misconduct and punishment. RESULTS There were 62.7% (471/751) of convicted and disciplined physicians (cases) with web-based ratings and 64.6% (485/751) of nondisciplined physicians (controls) with ratings. Of 312 matched case-control pairs, disciplined physicians were rated lower than controls overall (3.62 vs 4.00; <i>P</i>&lt;.001). Disciplined physicians had lower ratings for all types of misconduct and punishment—except for physicians disciplined for sexual offenses (n=90 pairs; 3.83 vs 3.86; <i>P</i>=.81). Sexual misconduct was the only category in which mean ratings for physicians were higher than those for other disciplined physicians (3.63 vs 3.35; <i>P</i>=.003) CONCLUSIONS Physicians convicted for disciplinary misconduct generally had lower web-based ratings. Physicians convicted of sexual misconduct did not have lower ratings and were rated higher than other disciplined physicians. These findings may have future implications for the identification of physicians providing poor-quality care.

Trends in Health Quality-related Publications over the past three decades. (Preprint)

2021 ◽  
Author(s):  
Joseph Mendlovic ◽  
Francis B Mimouni ◽  
Iris Arad ◽  
Eyal Heiman
Keyword(s):  
Health Care ◽  
Health Care Quality ◽  
Case Reports ◽  
Quality Care ◽  
Care Quality ◽  
Publication Type ◽  
The Past ◽  
Management Quality ◽  
Rate Of Increase ◽  
Number Of Publications

BACKGROUND Quality assessment in health care is a process of planned activities whose ultimate goal is to achieve a continuous improvement of medical care through the evaluation of structure, process, and outcome measures. Physicians and health care specialists involved with quality issues are faced with an enormous and nearly always increasing amount of literature to read and integrate OBJECTIVE To test the hypothesis that the number of publications in the field of health care quality increases over time, and particularly the number of high-evidence journal articles such as randomized control trials, systematic reviews, and ultimately, practice guidelines. METHODS We used MEDLINE database to retrieve relevant articles published between during the 29 year-period between 1/1/1989 and 12/31/2018. The search was conducted in March 2021. Publications from 2019 and 2020 were excluded because of incomplete data. We used the keywords "quality care", "quality management", "quality indicators" and "quality improvement” and limited the search fields to title and abstract. RESULTS During the 29-year evaluation period there was a significant cubic increase in the number of publications both in total number of publications and in the variety of publication types studied The rate of increase varied for different types of publications, with the largest increase in reviews, and the smallest increase in case reports. There was a systematic stagnation or even decrease in the number of publications starting in 2015 regardless of publication type. CONCLUSIONS Over the past 29 years the field of quality in health care has seen a significant yearly increase of published original studies with a relative stagnation since 2015. We suggest that contributors to this dynamic field of research should focus on producing more evidence based publications and guidelines

scholarly journals The Endoscopy Global Rating Scale – Canada: Development And Implementation of a Quality Improvement Tool

2013 ◽  
Vol 27 (2) ◽  
pp. 74-82 ◽  
Author(s):  
Donald MacIntosh ◽  
Catherine Dubé ◽  
Roger Hollingworth ◽  
Sander Veldhuyzen van Zanten ◽  
Sandra Daniels ◽  
...  
Keyword(s):  
Health Care ◽  
Health Care Quality ◽  
Rating Scale ◽  
Two Dimensions ◽  
Care Quality ◽  
Global Rating Scale ◽  
Global Rating ◽  
Charge Nurse ◽  
The Uk

BACKGROUND: Increasing use of gastrointestinal endoscopy, particularly for colorectal cancer screening, and increasing emphasis on health care quality highlight the need for endoscopy facilities to review the quality of the service they offer.OBJECTIVE: To adapt the United Kingdom Global Rating Scale (UK-GRS) to develop a web-based and patient-centred tool to assess and improve the quality of endoscopy services provided.METHODS: Based on feedback from 22 sites across Canada that completed the UK endoscopy GRS, and integrating results of the Canadian consensus on safety and quality indicators in endoscopy and other Canadian consensus reports, a working group of endoscopists experienced with the GRS developed the GRS-Canada (GRS-C).RESULTS: The GRS-C mirrors the two dimensions (clinical quality and quality of the patient experience) and 12 patient-centred items of the UK-GRS, but was modified to apply to Canadian health care infrastructure, language and current practice. Each item is assessed by a yes/no response to eight to 12 statements that are divided into levels graded D (basic) through A (advanced). A core team consisting of a booking clerk, charge nurse and the physician responsible for the unit is recommended to complete the GRS-C twice yearly.CONCLUSION: The GRS-C is intended to improve endoscopic services in Canada by providing endoscopy units with a straightforward process to review the quality of the service they provide.

scholarly journals Association Between Web-Based Physician Ratings and Physician Disciplinary Convictions: Retrospective Observational Study

10.2196/16708 ◽  
2020 ◽  
Vol 22 (5) ◽  
pp. e16708
Author(s):  
Jessica Janine Liu ◽  
Hanna R Goldberg ◽  
Eric JM Lentz ◽  
John Justin Matelski ◽  
Asim Alam ◽  
...  
Keyword(s):  
Observational Study ◽  
Health Care Quality ◽  
Quality Care ◽  
Sexual Misconduct ◽  
Poor Quality ◽  
Care Quality ◽  
Web Based ◽  
Sexual Offenses ◽  
Physician Rating ◽  
Physician Rating Website

Background Physician rating websites are commonly used by the public, yet the relationship between web-based physician ratings and health care quality is not well understood. Objective The objective of our study was to use physician disciplinary convictions as an extreme marker for poor physician quality and to investigate whether disciplined physicians have lower ratings than nondisciplined matched controls. Methods This was a retrospective national observational study of all disciplined physicians in Canada (751 physicians, 2000 to 2013). We searched ratings (2005-2015) from the country’s leading online physician rating website for this group, and for 751 matched controls according to gender, specialty, practice years, and location. We compared overall ratings (out of a score of 5) as well as mean ratings by the type of misconduct. We also compared ratings for each type of misconduct and punishment. Results There were 62.7% (471/751) of convicted and disciplined physicians (cases) with web-based ratings and 64.6% (485/751) of nondisciplined physicians (controls) with ratings. Of 312 matched case-control pairs, disciplined physicians were rated lower than controls overall (3.62 vs 4.00; P<.001). Disciplined physicians had lower ratings for all types of misconduct and punishment—except for physicians disciplined for sexual offenses (n=90 pairs; 3.83 vs 3.86; P=.81). Sexual misconduct was the only category in which mean ratings for physicians were higher than those for other disciplined physicians (3.63 vs 3.35; P=.003) Conclusions Physicians convicted for disciplinary misconduct generally had lower web-based ratings. Physicians convicted of sexual misconduct did not have lower ratings and were rated higher than other disciplined physicians. These findings may have future implications for the identification of physicians providing poor-quality care.

Enterprise Liability for Medical Malpractice and Health Care Quality Improvement

1994 ◽  
Vol 20 (1-2) ◽  
pp. 1-28
Author(s):  
William M. Sage ◽  
Kathleen E. Hastings ◽  
Robert A. Berenson
Keyword(s):  
Health Care ◽  
Quality Improvement ◽  
Medical Malpractice ◽  
Health Care Quality ◽  
Care Quality ◽  
Pattern Of Care ◽  
The Past ◽  
Solo Practice ◽  
Health Care Quality Improvement ◽  
Guide Care

[Assumptions about quality in health care and its defense] are rooted in the past, a past in which the doctor ruled. Strangely, those assumptions have survived the revolutions that now deny the doctor the sole authority to judge and guide care. The doctor no longer really controls health care, as in the days of solo practice, but, when it comes to quality, the doctor is still held accountable. When the researchers study quality, they focus on the behavior of the physician. When the Quality Assurance Committee meets, it reviews the performance of the physician. When the payers and the regulators turn on their searchlights, they want doctors in their glare. Control is shifting, structure is shifting, the pattern of care is shifting; but accountability is not.This passage prefaces a landmark report on the application to health care of quality improvement methods used successfully in other industries.

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