Word of Mouth and Online Reviews Are More Influential Than Social Media for Patients When Selecting a Sports Medicine Physician

Internet-Based Patient Portals Increase Patient Connectivity Following Total Knee Arthroplasty

Many healthcare-related processes have undergone substantial transformation by the internet since the turn of the century. This technological revolution has fostered a fundamental shift from medical paternalism to patient autonomy and empowerment via a "patient-centric approach." Patient portals, or internet-enabled access to an electronic medical record, permit patients to access, manage, and share their health-related information. Patient connectivity following total knee arthroplasty (TKA) has the potential to positively influence overall outcomes, patient experience, and satisfaction. To understand current trends in patient portal usage, modalities of connectivity, and the implications following TKA. A systematic literature review was performed by searching PubMed and Google Scholar. Articles specific to portal usage and connectivity after TKA or total joint arthroplasty were subsequently identified for further review. Patient portals and internet-based digital connectivity platforms enable physicians, team members, and patients to communicate in the perioperative period both directly and indirectly. Communication can be through web-based patient portals, messaging services/apps, preprogrammed alerts (e.g., mobile applications or wearable devices), audio mediums, or videoconferencing. The spectrum and utilization of available patient engagement platforms continues to expand as the importance and implications of patient engagement and connectivity continue to be elucidated. Connectivity through patient portals or other mediums will continue to have an expanding role in all aspects of orthopedic surgery, patient care, and engagement. This includes preoperative education, postoperative rehabilitation, patient care, and, perhaps most importantly, collection of outcome measures. The level of evidence is V (expert opinion).

Below-Knee Amputations: A Qualitative Social Media Analysis of Perceived Outcomes

INTRODUCTION

Below-knee amputations (BKAs) treat lower-limb conditions such as ischemia, peripheral artery disease, and trauma. This study uses social media to examine patient outcomes and perspectives post-BKA.

METHODS

Data from Facebook, Instagram, and X (formerly Twitter) from February 26, 2014, to February 26, 2024, were analyzed. Posts from the Facebook groups "Amputee Support Group" and "Below Knee Amputee," along with posts tagged with #belowkneeamputation and #belowkneeamputee on Instagram and X, were examined for demographics, perspective, and perceived outcomes.

RESULTS

Analysis of 571 Facebook posts, 520 Instagram posts, and 64 X posts revealed 67% positive outcomes, 20.1% neutral, and 12.9% negative. Instagram showed the most positive responses, often from patients resuming physical activities. Facebook was predominant with neutral posts seeking advice, while X displayed mostly positive feedback. Negative feedback on Facebook centered on phantom pain and reduced quality of life.

DISCUSSION AND CONCLUSION

Most BKA patients reported positive postoperative outcomes. Facebook emerged as a vital platform for individuals to share their challenges and seek support, enabling them to join specialized support groups where they can connect with others facing similar issues and receive advice and encouragement. Negative outcomes, often related to persistent pain and dissatisfaction with life quality, underscore the need for surgeons to manage expectations and address physical and emotional recovery aspects of BKA.

Sports Medicine Surgeons Use Social Media to Network With Other Surgeons and Increase Patient Engagement: A Scoping Review

PURPOSE

To identify how social media is used by sports medicine surgeons and how this is perceived by patients.

METHODS

In accordance with Preferred Reporting Items for Systematic Reviews and Meta-analyses for Scoping Reviews (PRISMA-ScR) guidelines, the PubMed, Embase, and Cochrane Library databases were searched in April 2024 for studies published after 2014. Studies were included if they met the following criteria: They evaluated sports medicine fellowship-trained orthopaedic surgeons' social media use or patient preferences regarding social media use among these surgeons, reported the purpose of social media use, and were written in English. Studies that were not written in English, did not specifically evaluate sports medicine surgeons, or evaluated a singular procedure were excluded.

RESULTS

The initial search identified 328 studies, 6 of which were included in this scoping review, each of which was a cross-sectional study. Of these studies, 4 (67%) evaluated how sports medicine surgeons use social media and 2 (33%) evaluated patient experiences of consuming surgeons' social media content. Twitter was the most popular social media site among sports medicine orthopaedic surgeons with online social media presence scores in the top 10%. Academic sports medicine surgeons were more likely than nonacademic surgeons to be active on social media. Increased Twitter use was correlated with increased research productivity and citation impact. Patients were interested in educational videos and live question-and-answer sessions from their sports medicine surgeons, irrespective of platform used.

CONCLUSIONS

Twitter and YouTube are popular platforms among sports medicine surgeons, particularly for professional networking and patient education. However, Instagram has emerged as the leading platform in terms of user engagement, making it an effective tool for fostering patient interaction and promoting clinical practice. These findings suggest that surgeons should prioritize Instagram alongside other platforms to effectively enhance their professional presence.

LEVEL OF EVIDENCE

Level III, systematic review of Level III studies.

Word-of-mouth referrals between patients are a critical component of medical tourism for pediatric hematopoietic cell transplantation

The increasing popularity of medical tourism has sparked interest from policymakers, researchers, and the media. Factors influencing medical tourism include service quality, availability, economics, and cultural differences. This study aims to analyze the key factors that influence destination selection for medical tourists. We conducted a thorough examination of hematopoietic cell transplantation (HCT) data from the pediatric population at our institution from 2006 onwards, focusing on the aspect of medical tourism. Most connections to services were made through encounters in patients' daily lives and environments, such as word-of-mouth (WOM) from previously treated patients, family, or friends; connection through other services; referral from health care professionals; and seeing the service in their neighborhood. The results of our study indicate that the outcomes of these patients were comparable to those of patients with unrelated donor HCT who were not from an international background. Approximately 55% of our patients were referred to those who previously received treatment. Effective WOM referrals between patients are essential to the success of a medical tourism business. Patients referred to hospitals tend to have higher satisfaction rates and are more likely to become repeat customers. This ultimately leads to increased revenue and a stronger reputation in the industry. Additionally, positive feedback from satisfied patients can significantly enhance an organization's reputation and attract more potential clients. Chinese tourists and Taiwanese people share language and history. Engaging in direct conversations with physicians regarding personal matters has proven to be more effective than depending on the translator. WOM referrals are critical components of the medical tourism industry. The results indicate that WOM referrals play an essential role in conveying patients' experiences, leading to increased revenue and a stronger reputation in the industry.

Choosing a thoracic surgeon in Türkiye: Which criteria do patients pay attention to?

Background

This study aims to identify main factors playing a role in patient's selection of a thoracic surgeon in Türkiye.

Methods

Between July 2022 and June 2024, a total of 147 patients (96 males, 41 females; mean age: 56.1±14.7 years; range, 19 to 93 years) who underwent lung resection and completed an anonymous questionnaire sent via e-mail or cell-phone were included. Demographic data of the patients, surgeon's educational and medical background, advertisements and popularity, age and sex, appearance and communication skills, and surgeon's working center were evaluated.

Results

"Spending adequate time with patients" had the highest score, while "the distance between surgeon's center and patient's home" had the lowest score. In general, criteria about surgeon's appearance and communication skills, and surgeon's working center had significantly the highest rates, whereas those of surgeon's advertisements and popularity had the lowest rates (p<0.05). Recommendation by another doctor or family doctor was insignificantly more important than by non-medical person. Patients were not influenced with internet reviews or scoring about the surgeon, presence of surgeon's personal web page, or social media accounts, or age/sex of the surgeon (p>0.05).

Conclusion

Turkish patients mostly take into consideration the attitudes of the surgeon rather than surgeon's reputation and professional experience, while selecting a thoracic surgeon. Surgeon-patient interaction is highly important for Turkish patients. Social media and advertisements are not important criteria in the selection of thoracic surgeon in Türkiye.

The rise of multidisciplinary clinics in hepatology: A practical, how-to-guide, and review of the literature

Multidisciplinary clinics (MDCs) are gaining momentum throughout the medical field, having initially been pioneered in oncology clinics due to their inherent ability to streamline complex care and improve both patient outcomes and the patient care experience. Liver transplant and hepatobiliary tumor clinics are examples of established MDCs in hepatology. With the changing landscape of liver disease in regard to etiology and patient complexity and acuity, there is a clear need for efficient, highly coordinated care. These changes highlight opportunities for hepatology MDCs in alcohol-associated liver disease, metabolic dysfunction-associated steatotic liver disease, and palliative care. This review provides practical advice in navigating the complex logistics of establishing and maintaining a hepatology MDC while also reviewing the emerging evidence on clinical outcomes for patients seen in these MDCs. As hepatology looks to the future, establishment of MDCs in key clinical areas will be the cornerstone of patient care.

Athlete-Specific Considerations of Cartilage Injuries

Cartilage injuries can present in a diverse setting of anatomic locations, with varying severity, and can impact athletes of all ages and competition levels. Moreover, the timing of when an injury presents introduces an additional dimension to treatment decision-making. Frequently, the level of competition, in conjunction with career trajectory and short-term and long-term athlete goals, will dictate whether a temporary or definitive treatment strategy is ideal. Although indicating the correct therapeutic regimen may prove challenging, understanding the athlete-specific considerations can be essential to meeting the goals of the athlete and other stakeholders involved in the athlete's career. The purpose of this review is to comprehensively present the deliberations a treating physician must consider in managing cartilage injuries within a spectrum of athletic levels ranging from youth to professional levels, with a secondary focus on the presentation of temporizing treatment strategies and associated outcomes.

Assessing the Benefits and Downsides of Physician Review Websites to Plastic Surgeons: A Cost-Benefit Analysis

BACKGROUND

Patients often evaluate the reputations of plastic surgeons based on their performances on physician review websites. This article aims to compare rating methodologies and conduct a cost-benefit analysis of physician review websites to further understand how plastic surgeons and their patients can utilize review websites to inform their practice and care.

METHODS

A review of online literature, blogs, and 17 of the most common physician review websites was conducted to identify information on review website methodology, cost, and benefits most pertinent to plastic surgeons and their patients.

RESULTS

Physician review websites utilize various combinations of physician-related and unrelated criteria to evaluate plastic surgeons. Across 17 reviewed platforms, most (71%) utilize star ratings to rate physicians, 18% require an appointment to conduct a review, and 35% feature search engine optimization. Many websites (53%) allow physicians to pay for benefits or extension packages, with benefits offered including advertising, search engine optimization, competitor blocking, social media marketing, consultant services, and data analytics. Competitor blocking was provided by the most number of websites who offered additional services for pay (78%).

CONCLUSIONS

Appointments are not required to post physician reviews on many review websites, and many websites allow physicians to purchase packages to enhance their search engine optimization or consumer reach. Accordingly, plastic surgeons' reputations on review websites may be influenced by factors extraneous to actual patient care. Patients and physicians should be cognizant that physician review websites may not be reflective of factors related to quality of patient care.

Periacetabular osteotomy: an analysis of social media to determine the most common questions asked by the periacetabular osteotomy population

BACKGROUND

The Bernese Periacetabular Osteotomy (PAO) has become a popular surgery for fixing development dysplasia of the hip, yet the most common concerns of the PAO population remains ambiguous. The aim of this study was to investigate Facebook, Instagram and Twitter to further understand what the most common preoperative and postoperative questions patients undergoing PAO are asking. We hypothesized most questions would be asked by patients in the preoperative timeframe with regards to education surrounding PAO surgery.

METHODS

Facebook, Instagram and Twitter were queried consecutively from February 1, 2023 to November 23, 2011. Facebook was searched for the two most populated interest groups; "Periacetabular Osteotomy (PAO)" and "Periacetabular Osteotomy Australia". Instagram and Twitter were queried for the most popular hashtags: "#PAOwarrior", "#PAOsurgery", "#periacetabularosteotomy", "#periacetabularosteotomyrecovery", and "#paorecovery". Patient questions were categorized according to preoperative and postoperative questions. Questions were further placed into specific themes in their respective preoperative or postoperative question types.

RESULTS

Two thousand five hundred and fifty-nine posts were collected, with 849 (33%) posts containing 966 questions. Of the 966 questions, 443 (45.9%) and 523 (54.1%) were preoperative and postoperative questions, respectively. The majority of questions were postoperative complication related (23%) and symptom management (21%). Other postoperative questions included recovery/rehabilitation (21%), and general postoperative questions (18%). The most common preoperative questions were related to PAO education (23%). Rehabilitation (19%), hip dysplasia education (17%), and surgeon selection (12%) were other preoperative questions topics included. Most questions came from Facebook posts. Of 1,054 Facebook posts, 76% were either preoperative or postoperative questions and from the perspective of the patient (87%).

CONCLUSION

The majority of patients in the PAO population sought advice on postoperative complications and symptom management. Some patients asked about education surrounding PAO surgery. Understanding the most common concerns and questions patients have can help providers educate patients and focus on more patient-relevant perioperative conversations.

Perceived outcomes of periacetabular osteotomy

Aims

Social media is a popular resource for patients seeking medical information and sharing experiences. periacetabular osteotomy (PAO) is the gold-standard treatment for symptomatic acetabular dysplasia with good long-term outcomes. However, little is known regarding the perceived outcomes of PAO on social media. The aims of this study were to describe the perceived outcomes following PAO using three social media platforms: Facebook, Instagram, and X (formerly known as Twitter).

Methods

Facebook, Instagram, and X posts were retrospectively collected from 1 February 2023. Facebook posts were collected from the two most populated interest groups: "periacetabular osteotomy" and "PAO Australia." Instagram and X posts were queried using the most popular hashtags: #PAOwarrior, #periacetabularosteotomy, #periacetabularosteotomyrecovery, #PAOsurgery, and #PAOrecovery. Posts were assessed for demographic data (sex, race, location), perspective (patient, physician, professional organization, industry), timing (preoperative vs postoperative), and perceived outcome (positive, negative, neutral).

Results

A total of 1,054 Facebook posts, 1,003 Instagram posts, and 502 X posts were consecutively assessed from 887 unique authors. The majority (63.3%) of these posts were from patients in the postoperative period, with a median of 84 days postoperatively (interquartile range 20 to 275). The longest follow-up timeframe postoperatively was 20 years. Regarding perceived outcomes, 52.8% expressed satisfaction, 39.7% held neutral opinions, and 7.5% were dissatisfied. Most dissatisfied patients (50.9%) reported pain (chronic or uncontrolled acute) as an attributing factor.

Conclusion

Most PAO-perceived surgical outcomes on social media had a positive tone. Findings also indicate that a small percentage of patients reported negative perceived outcomes. However, dissatisfaction with PAO primarily stemmed from postoperative pain. Social media posts from other sources (physicians, hospitals, professional organizations, etc.) trend towards neutrality. Healthcare providers must consider the social media narratives of patients following PAO, as they may reveal additional outcome expectations and help improve patient-centred care, create informed decision-making, and optimize treatment outcomes.