COPYRIGHT © SLACK INCORPORATED n Feature Article A current focus of health care re- form in the United States is improved transparency of the quality of care at the provider level. For hospitals and individual physicians, finan- cial incentives are increasingly linked to the quality of patient care, and physician engagement in the evaluation of these measures is critical. A controversial area of quality reporting is patient satisfac- tion. 1-10 Currently, patient satisfaction outcomes from the Hospital Consumer Assessment of Healthcare Providers and Systems survey are a component of the total performance score linked to hospital value-based purchasing reimbursement from Medicare, suggesting that, at a payer level, patient satisfaction measures are Provider-Initiated Patient Satisfaction Reporting Yields Improved Physician Ratings Relative to Online Rating Websites BENJAMIN F. RICCIARDI, MD; BRAD S. WADDELL, MD; SCOTT R. NODZO, MD; JEFFREY LANGE, MD; ALLINA A. NOCON, MPH; SPENCER AMUNDSEN, MD; T. DAVID TARITY, MD; ALEXANDER S. MCLAWHORN, MD, MBA The authors are from the Adult Reconstruction and Joint Replacement Service (BFR, BSW, SRN, JL, SA, TDT, ASM) and the Complex Joint Recon- struction Center (AAN), Hospital for Special Sur- gery, New York, New York. The authors have no relevant financial rela- tionships to disclose. Correspondence should be addressed to: Benjamin F. Ricciardi, MD, Adult Reconstruction and Joint Replacement Service, Hospital for Spe- cial Surgery, 535 E 70th St, New York, NY 10021 (ricciardib1111@gmail.com). Received: April 9, 2017; Accepted: July 10, 2017. doi: 10.3928/01477447-20170810-03 Recently, providers have begun to publicly report the results of patient satisfac- tion surveys from their practices. However, these outcomes have never been compared with the findings of commercial online physician rating websites. The goals of the current study were to (1) compare overall patient satisfaction ratings for orthopedic surgeons derived from provider-based third-party sur- veys with existing commercial physician rating websites and (2) determine the association between patient ratings and provider characteristics. The authors identified 12 institutions that provided publicly available patient satisfaction outcomes derived from third-party surveys for their orthopedic surgeons as of August 2016. Orthopedic surgeons at these institutions were eligible for inclu- sion (N=340 surgeons). Provider characteristics were recorded from publicly available data. Four high-traffic commercial online physician rating websites were identified: Healthgrades.com, UCompareHealthCare.com, Vitals.com, and RateMDs.com. For each surgeon, overall ratings (on a scale of 1-5), total number of ratings, and percentage of negative ratings were compared between provider-initiated internal ratings and each commercial online website. Asso- ciations between baseline factors and overall physician ratings and negative ratings were assessed. Provider-initiated internal patient satisfaction ratings showed a greater number of overall patient ratings, higher overall patient satis- faction ratings, and a lower percentage of negative comments compared with commercial online physician rating websites. A greater number of years in practice had a weak association with lower internal ratings, and an academ- ic practice setting and a location in the Northeast were protective factors for negative physician ratings. Compared with commercial online physician rating websites, provider-initiated patient satisfaction ratings of orthopedic surgeons appear to be more favorable, with greater numbers of responses. [Orthopedics. 2017; 40(5):304-310.] abstract 304