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Original Investigation |

Evaluation of Dermatology Practice Online Reviews Lessons From Qualitative Analysis

Robert J. Smith, BS1,2; Jules B. Lipoff, MD1
[+] Author Affiliations
1Department of Dermatology, Perelman School of Medicine, University of Pennsylvania, Philadelphia
2Social Media and Health Innovation Lab, Penn Medicine Center for Health Care Innovation, University of Pennsylvania, Philadelphia
JAMA Dermatol. 2016;152(2):153-157. doi:10.1001/jamadermatol.2015.3950.
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Importance  Patient satisfaction is an increasingly important component of health care quality measures. Online reviews of physicians represent a promising platform for capturing patient perspectives of care.

Objective  To identify qualitative themes associated with patient reviews of dermatologic care on consumer reporting websites.

Design, Setting, and Participants  A qualitative analysis was conducted of patient-generated reviews of dermatology practices on 2 consumer review platforms. Yelp is an online consumer portal for users to review their experience with local businesses; ZocDoc is an online patient-scheduling portal that provides opportunity for patients to write reviews of physician practices. A total of 518 reviews from 45 dermatology practices on Yelp and 4921 reviews from 45 dermatology providers on ZocDoc were collected from 3 geographically diverse cities: Philadelphia, Pennsylvania; Houston, Texas; and Seattle, Washington. The study was conducted from January 15 to July 15, 2015.

Main Outcomes and Measures  Reviews were separated into high-scoring and low-scoring groups. An inductive qualitative method was used to code and identify key themes associated with positive and negative patient experiences. Analysis was completed upon reaching thematic saturation.

Results  Reported as mean (95% CI), the overall Yelp score for the 45 selected practices was 3.46 of 5 stars (3.17-3.75) and overall ZocDoc score for the 45 selected practices was 4.72 of 5 stars (4.47-4.80). The proportion of individual reviews giving a score of 5.0 was significantly higher on ZocDoc (3986 [81.0%]) than on Yelp (229 [44.2%]) (P < .001). Qualitative themes centered on characteristics of the physician and the practice. Themes that emerged from the high-scoring and low-scoring reviews were similar in content but opposite in valence. Physician-specific themes included temperament, knowledge and competency, physical examination, communication abilities, and mindfulness of cost. Practice-specific themes included scheduling, staff temperament, office cleanliness, waiting room, and insurance. Patients appreciated physicians who are kind, respectful, and thorough with the physical examination; empathetic about the emotional difficulty of skin disease; and cognizant of cost. Negative experiences were frequently affected by considerations outside of the physician-patient interaction, such as curt interactions with staff, difficulty with scheduling, practice cleanliness, and insurance problems. Patients reported relying on consumer websites to identify dermatology providers.

Conclusions and Relevance  Online consumer review websites are designed to facilitate instantaneous and public communication among patients. These platforms provide elaborate and timely data for dermatologists to garner insight into their patients’ experiences. The themes identified in this study are consistent with past satisfaction studies and may aid dermatologists in optimizing the patient care experience.

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Figure 1.
Mean Physician Score Distribution

Distribution of mean review scores for a sample of dermatologists on Yelp (n = 45) and ZocDoc (n = 45).

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Figure 2.
Individual Review Score Distribution

Distribution of individual reviews for dermatology practices on Yelp (n = 518) and ZocDoc (n = 4921) compared with distribution of reviews across all of Yelp reviews.

aP < .05 for difference in proportion of scores compared with ZocDoc.

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The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
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