Every Orthopaedic Surgeon should be aware of the content posted on the Internet. Our recommendation is for surgeons to routinely evaluate content posted on publically available venues for professionalism.

Background Patient attitudes and behavior are critical to understand owing to the increasing role of patient choice. There is a paucity of investigation into the perceived credibility of online information and whether such information impacts how patients choose their surgeons. Objective The purpose of this study was to explore the attitudes and behavior of patients regarding online information and orthopedic surgeon selection. Secondary purposes included gaining insight into the relative importance of provider selection factors, and their association with patient age and education level. Methods This was a cross-sectional study involving five multispecialty orthopedic surgery groups. A total of 329 patients who sought treatment by six different orthopedic surgeons were asked to anonymously answer a questionnaire consisting of 25 questions. Four questions regarded demographic information, 10 questions asked patients to rate the importance of specific criteria regarding the selection of their orthopedic surgeon (on a 4-point Likert scale), and 6 questions were designed to determine patient attitude and behaviors related to online information. Results Patient-reported referral sources included the emergency room (29/329, 8.8%), friend (42/329, 12.8%), insurance company (47/329, 14.3%), internet search/website (28/329, 8.5%), primary care physician (148/329, 45.0%), and other (34/329, 10.3%). Among the 329 patients, 130 (39.5%) reported that they searched the internet for information before their first visit. There was a trend of increased belief in online information to be accurate and complete in younger age groups (P=.02). There was an increased relative frequency in younger groups to perceive physician rating websites to be unbiased (P=.003), provide sufficient patient satisfaction information (P=.01), and information about physician education and training (P=.03). There was a significant trend for patients that found a surgeon’s website to be useful (P<.001), with the relative frequency increased in younger age groups. Conclusions This study shows that insurance network, physician referrals, appointment availability, and office location are important to patients, whereas advertising and internet reviews by other patients were considered to be not as helpful in choosing an orthopedic surgeon. Future studies may seek to identify obstacles to patients in integrating online resources for decision-making and strategies to improve health-seeking behaviors.

BACKGROUND As patient access to consumer review websites, medical provider information available on the internet, as well as increasing direct consumer healthcare advertising, elective orthopedic surgery has become more patient and market-driven. OBJECTIVE Our goal is to determine the importance of physician ratings and review websites and the role these websites have in the decision to establish care with an orthopedic subspecialist. METHODS Cross-sectional study involving 5 multi-specialty orthopedic surgery groups. 328 patients who sought treatment by 6 different orthopedic surgeons were asked to anonymously answer a questionnaire consisting of 25 questions. We asked demographic information and asked patients to rate the importance of specific criteria regarding the selection of their orthopedic surgeon. RESULTS Across all ages, 79% of respondents selected it was very important that the surgeon is covered by their insurance. Out of pocket cost was very important to 66% and moderately important to 19% of the respondents. Only 39% of the respondents searched for information about the doctor on the internet. Recommendations from family or friends to the surgeon were moderately or very important to only 61%. The surgeon’s website was visited by 49% of respondents, followed by the website of the office or surgical group at 27%. CONCLUSIONS Our findings suggest that insurance coverage, insurance network coverage, and out-of-pocket cost are very important in patient’s choice of their orthopedic surgeon. Television and print advertising played little to no role in choosing a surgeon for the majority of patients surveyed. Patients' rising role in health care provider selection makes understanding elements that affect their decision imperative. CLINICALTRIAL N/A