BackgroundThe growth in the volume of online patient feedback, including online patient ratings and comments, suggests that patients are embracing the opportunity to review online their experience of receiving health care. Very little is known about health care professionals’ attitudes toward online patient feedback and whether health care professionals are comfortable with the public nature of the feedback.ObjectiveThe aim of the overall study was to explore and describe general practitioners’ attitudes toward online patient feedback. This paper reports on the findings of one of the aims of the study, which was to explore and understand the concerns that general practitioners (GPs) in England have about online patient feedback. This could then be used to improve online patient feedback platforms and help to increase usage of online patient feedback by GPs and, by extension, their patients.MethodsA descriptive qualitative approach using face-to-face semistructured interviews was used in this study. A topic guide was developed following a literature review and discussions with key stakeholders. GPs (N=20) were recruited from Cambridgeshire, London, and Northwest England through probability and snowball sampling. Interviews were transcribed verbatim and analyzed in NVivo using the framework method, a form of thematic analysis.ResultsMost participants in this study had concerns about online patient feedback. They questioned the validity of online patient feedback because of data and user biases and lack of representativeness, the usability of online patient feedback due to the feedback being anonymous, the transparency of online patient feedback because of the risk of false allegations and breaching confidentiality, and the resulting impact of all those factors on them, their professional practice, and their relationship with their patients.ConclusionsThe majority of GPs interviewed had reservations and concerns about online patient feedback and questioned its validity and usefulness among other things. Based on the findings from the study, recommendations for online patient feedback website providers in England are given. These include suggestions to make some specific changes to the platform and the need to promote online patient feedback more among both GPs and health care users, which may help to reduce some of the concerns raised by GPs about online patient feedback in this study.

BackgroundPatient feedback websites or doctor rating websites are increasingly being used by patients to give feedback about their health care experiences. There is little known about why patients in England may give Web-based feedback and what may motivate or dissuade them from giving Web-based feedback.ObjectiveThe aim of this study was to explore patients’ views toward giving Web-based feedback and ratings to general practitioners (GPs), within the context of other feedback methods available in primary care in England, and in particular, paper-based feedback cards.MethodsA descriptive exploratory qualitative approach using face-to-face semistructured interviews was used in this study. Purposive sampling was used to recruit 18 participants from different age groups in London and Coventry. Interviews were transcribed verbatim and analyzed using applied thematic analysis.ResultsHalf of the participants in this study were not aware of the opportunity to leave feedback for GPs, and there was limited awareness about the methods available to leave feedback for a GP. The majority of participants were not convinced that formal patient feedback was needed by GPs or would be used by GPs for improvement, regardless of whether they gave it via a website or on paper. Some participants said or suggested that they may leave feedback on a website rather than on a paper-based feedback card for several reasons: because of the ability and ease of giving it remotely; because it would be shared with the public; and because it would be taken more seriously by GPs. Others, however, suggested that they would not use a website to leave feedback for the opposite reasons: because of accessibility issues; privacy and security concerns; and because they felt feedback left on a website may be ignored.ConclusionsPatient feedback and rating websites as they currently are will not replace other mechanisms for patients in England to leave feedback for a GP. Rather, they may motivate a small number of patients who have more altruistic motives or wish to place collective pressure on a GP to give Web-based feedback. If the National Health Service or GP practices want more patients to leave Web-based feedback, we suggest they first make patients aware that they can leave anonymous feedback securely on a website for a GP. They can then convince them that their feedback is needed and wanted by GPs for improvement, and that the reviews they leave on the website will be of benefit to other patients to decide which GP to see or which GP practice to join.

BackgroundWith the advent and popularity of social media and consumer rating websites, as well as the emergence of the digitally engaged patient, there has been an increased interest in doctor rating websites or online patient feedback websites, both inside and outside academia. However, there is very little known about how the public across England views such rating websites as a mode to give patient experience feedback.ObjectiveThe aim of the overall study was to measure and understand public awareness, usage, and attitudes towards doctor rating websites as a mode to give experiential feedback about GPs in general practice in England. This paper reports on the findings of one of the aims of the study, which was to measure public awareness, current usage and future consideration of usage of online patient feedback websites, within the context of other feedback methods, This could allow the value of online patient feedback websites to be determined from the patients’ perspective.MethodsA mixed methods population questionnaire was designed, validated and implemented face-to-face using a cross-sectional design with a representative sample of the public (n=844) in England. The results of the questionnaire were analyzed using chi-square tests, binomial logistic regressions, and content analysis. The qualitative results will be reported elsewhere.ResultsPublic awareness of online patient feedback websites as a channel to leave experiential feedback about GPs was found to be low at 15.2% (128/844). However, usage and future consideration to use online patient feedback websites were found to be extremely low, with current patient usage at just 0.4% (3/844), and patient intention to use online patient feedback in the future at 17.8% (150/844). Furthermore, only 4.0-5.0% of those who would consider leaving feedback about a GP in the future selected doctor rating websites as their most preferred method; more than half of patients said they would consider leaving feedback about GPs using another method, but not using an online patient feedback website.ConclusionsThe findings suggest that online patient feedback websites may not be an effective channel for collecting feedback on patient experience in general practice. Feedback on online patient feedback websites is not likely to be representative of the patient experience in the near future, challenging the use of online patient feedback not just as a mode for collecting patient experience data, but for patient choice and monitoring too. We recommend the National Health Service channels its investment and resources towards providing more direct and private feedback methods in general practice (such as opportunities for face-to-face feedback, email-based feedback, and web-based private feedback forms), as these are currently much more likely to be used by the majority of patients in England.

In 2012, I conducted my first PhD study exploring general practitioners' attitudes toward online patient feedback. After designing the research questions and topic guide to conduct the interviews, I reviewed existing literature where authors described recruiting general practitioners to take part in research. I found there was some focus in the literature on the challenges associated with low general practitioner participation in survey-based and intervention studies, but little that described the process, experience, and challenges associated with recruiting general practitioners to take part in qualitative research. Although general practitioners are known to be a difficult group to recruit to take part in research, the recruitment process I experienced was much more challenging than I had anticipated. This case study sheds light on my experience of recruiting 20 general practitioners in England to an interview-based study, and outlines a critical reflection on the eight strategies used for recruitment. I started by using traditional methods such as postal invitations and faxes to recruit general practitioners. Due to the very low success rate, I resorted to using more inexpensive and creative methods, such as sending an invitation letter through email, advertising in general practitioner Email Newsletters, seeking help from existing research networks, recruiting through friends and acquaintances, and using social media. In this case study, I also describe the participants' (general practitioners') motivations for taking part in the study, and I conclude with offering suggestions on how to maximize response rates to general practitioner-based qualitative studies in England. Learning Outcomes By the end of the case, students should be able to Have a better understanding of the potential challenges faced when recruiting general practitioners (GPs) to take part in research Understand that sometimes probability sampling cannot be used due to difficulties with recruiting Learn to be creative and flexible when recruiting participants to research Understand the strategies and approaches that could be used to increase GP participation in research Project Overview and Context In 2012, I embarked on conducting a qualitative interview study with general practitioners (GPs), exploring their attitudes toward online patient feedback. GPs are the first point of call for patients in the United Kingdom. They treat all common medical conditions and refer patients to hospitals or other medical services for specialist or urgent care. Once my research questions and interview topic guide was designed, I focused my energies on exploring what strategies I should use for recruiting GPs to the study and what type of response rate I should expect.

The first four months of our daughter's life were very difficult. She cried constantly during the day, napped for only five to 10 minute durations, breastfed for two to five minutes at a time, hiccupped at least 50 times in one go three to four times a day, and made strange grunting noises in her sleep. When I sought help from healthcare professionals, they always began by asking if I was a first time mother. I was. They would then sigh and tell me that my baby's behaviour was completely normal: "It's just a bit of colic, it'll pass." I began to feel as if they'd labelled me as a hypochondriac because my daughter was my first child. I wanted them to investigate, to ask for details about when she cried, how much she cried, whether there was anything else we were worried about; we wanted them to explain colic. On the suggestion of other mothers, we got our daughter's posterior tongue tie and lip tie lasered, and took her for cranial osteopathy, but they didn't help.