Patient satisfaction surveys: who benefits?

Online physician reviews are becoming increasingly popular, at least among patients but maybe not so much among physicians, according to Leigh et al's study of physicians' perceptions of patient reviews.1 Over the past 30 years, the Internet has facilitated the sharing of information on a wide range of businesses, including healthcare organizations. Patient reviews (PRs) provide patients with a means to communicate their attitudes toward their physicians. Online platforms, such as Google and Yelp, allow patients to find physicians, schedule appointments, and review their experiences with physicians.2 These platforms offer content supplementing far more limited anecdotal information from friends or family (Table 1). Leigh et al.1 reported on dermatologists' perception of PRs and the impact PRs may have on improving patient care. Out of 137 participants surveyed, 88% reported receiving institutional data on their PRs, which contributed to greater overall stress compared with dermatologists who did not receive institutional feedback on their PRs, 59 and 41% (P < 0.05), respectively. Participants disclosed comparison to colleagues as a negative aspect of PRs. Of note, approximately 80% of participants reported symptoms of burnout from nondisclosed work demands.1 Many of these dermatologists viewed PRs negatively. While they felt that PRs are not helpful for patients, nor do they correlate with better care, they agreed that PRs have become more prevalent in the healthcare setting.1 Digital reviews could be considered a gift to physicians, helping them do what they want to do most: give patients the best possible care. The consensus from PRs is that patients emphasize bedside manner and clear communication from their provider.3 Implementing PRs at earlier stages of medical training may help providers get the feedback they need to optimize patients' experiences. The subjective feedback from PRs offers direct, qualitative information relevant to clinical encounters, which providers would not have access to otherwise. Dermatologists can utilize PRs as a tool to better understand patient experiences.4 Patients tend to express harsher, more negative reviews on general consumer websites (e.g., Google, Yelp) versus healthcare-specific websites (e.g., Zocdoc, Healthgrades).1 However, selection bias may be responsible for this phenomenon as high-volume search engines often filter for spontaneous reviews displaying rare patient grievances. Many physicians are often surprised by the quantity of positive reviews their patients post. This is precisely why dermatologists ought to encourage all patients to complete provider ratings – to help dilute the few reviews from unhappy patients and use the comments provided to improve future visits. PRs emerged as a method to improve the quality of care by assessing the patient's perception of the medical visit.1 Therefore, improved provider receptivity to PRs may help improve patient satisfaction, translating to better adherence to the provider's recommended treatment. As dermatologists aim to improve patient outcomes, promoting adherence to treatment involves the patient trusting that the physician is sincere and cares for their well-being. Embracing patient feedback by providers is an opportunity to build upon patient engagement and trust.4 PRs may also offer a scientific benefit; they help researchers identify patients' desires through quantitative analysis of patient ratings and assist providers in enhancing their patients' perceptions of care. Future use of PRs should focus on enhancing healthcare while meeting the expectations of both the patient and provider.