How do physician demographics, training, social media usage, online presence, and wait times influence online physician review scores for spine surgeons?

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The purpose of this study was to assess the impact of certain demographics, social media usage, and physician review website variables for spine surgeons across (Healthgrades), (Vitals), and (Google).


Through a directory of registered North American Spine Society (NASS) physicians, we identified spine surgeons practicing in Texas (107 neurosurgery trained, 192 orthopedic trained). Three physician rating websites (Healthgrades, Vitals, Google) were accessed to obtain surgeon demographics, training history, practice setting, number of ratings/reviews, and overall score (January 2, 2018–January 16, 2018). Using only the first 10 search results from, we then identified whether the surgeon had a website presence or an accessible social media account on Facebook, Twitter, and/or Instagram.


Physicians with either a personal or institutional website had a higher overall rating on Healthgrades compared to those who did not have a website (p < 0.01). Nearly all spine surgeons had a personal or institutional website (90.3%), and at least 1 accessible social media account was recorded for 43.5% of the spine surgeons in our study cohort (39.5% Facebook, 10.4% Twitter, 2.7% Instagram). Social media presence was not significantly associated with overall ratings across all 3 sites, but it did significantly correlate with more comments on Healthgrades. In multivariable analysis, increasing surgeon age was significantly associated with a lower overall rating across all 3 review sites (p < 0.05). Neurosurgeons had higher overall ratings on Vitals (p = 0.04). Longer wait times were significantly associated with a lower overall rating on Healthgrades (p < 0.0001). Overall ratings from all 3 websites correlated significantly with each other, indicating agreement between physician ratings across different platforms.


Longer wait times, increasing physician age, and the absence of a website are indicative of lower online review scores for spine surgeons. Neurosurgery training correlated with a higher overall review score on Vitals. Having an accessible social media account does not appear to influence scores, but it is correlated with increased patient feedback on Healthgrades. Identification of ways to optimize patients’ perception of care are important in the future of performance-based medicine.

ABBREVIATIONS NASS = North American Spine Society.

Article Information

Correspondence Chester J. Donnally III: University of Miami Hospital, Miami, FL.

INCLUDE WHEN CITING Published online November 23, 2018; DOI: 10.3171/2018.8.SPINE18553.

Disclosures Dr. Wang reports consultant relationships with DePuy-Synthes Spine, K2M, Spineology, Globus Medical, and Stryker; a patent holder relationship with DePuy-Synthes Spine; and direct stock ownership in ISD.

© AANS, except where prohibited by US copyright law.



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    Pearson correlation scatterplots. A: Healthgrades versus Vitals (r = 0.34, 95% CI 0.23–0.44, p < 0.0001). B: Healthgrades versus Google (r = 0.37, 95% CI 0.24–0.47, p < 0.0001). C: Vitals versus Google (r = 0.15, 95% CI 0.02–0.28, p = 0.03). v = versus. Figure is available in color online only.





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