“Finding a General Surgeon: Self-Referral in the Digital Era”

Abstract

Background As technology becomes more prominent in today’s society, more patients turn to the Internet to self-refer for a range of surgical problems. Frequently, patients search a nearby hospital’s website in order to find a physician. We hypothesized that the variability in hospital websites would make it difficult for patients to find a general surgeon for their care. Methods We used the US News and World Report’s Hospital Rankings 2018-2019 for this study. The “Find A Doctor” page within each hospital’s website was searched for the following conditions: “hernia” and “gallbladder.” Information on all suggested providers was collected, including medical specialty and gender. Descriptive statistics were used to analyze the data. Results The median number of providers listed in each search was 18 (range: 1-204). For “hernia,” general surgeons were not the majority of providers suggested at 12/16 institutions. For “gallbladder,” general surgeons were not the majority of providers suggested at 14/16 institutions, and 3/16 institutions did not suggest any. All 16 institutions suggested a strong majority of male providers (range: 62-100% male; median: 83% male). Discussion Considerable variation exists in the suggestion of medical providers for common general surgical problems among the top academic hospitals. Most notably, general surgeons are not listed as the primary providers for these conditions which they commonly manage. Health systems need to examine how their website suggest providers and ensure that patients can easily find the physician most suitable for their care.

Racial and Socioeconomic Disparities in Complex Abdominal Wall Reconstruction Referrals

“…There is potential for bias in referral patterns for hernia repair too. Contrastingly, many patients do not have a primary care physician and instead self-refer to a surgeon via an internet search [ 42 ]. This introduces another realm of disparity in health literacy, which could impact where patients choose to go for their hernia care.…”

One in Three Chance of Finding A Plastic Surgeon on Major Hospital Websites

“…Previous studies have also raised this concern in surgical oncology, general surgery, and endocrine surgery. 27–29…”

“…Previous studies have also raised this concern in surgical oncology, general surgery, and endocrine surgery. [27][28][29] This study has limitations. We utilized the top 20 ranked hospital systems in an attempt to represent all hospitals across the US; however, our conclusions are inherently not generalizable to individual hospitals or regions.…”

Patient Referrals for Hernia Consultations through the International Hernia Collaboration (IHC) Online Social Media Platform

“…There is very little published about how surgical referrals are actually performed. Gentry et al 2 evaluated patient-directed self-referral for surgical problems via Internet search through hospital websites and determined that general surgeons are frequently not listed as primary providers for general surgical problems. This makes patient access to general surgeons not as straightforward as it should be and further work is needed to create a more streamlined system for surgical referrals.…”