Unhappy Patients Are Not Alike: Content Analysis of the Negative Comments from China's Good Doctor Website

Abstract

BackgroundWith the rise in popularity of Web 2.0 technologies, the sharing of patient experiences about physicians on online forums and medical websites has become a common practice. However, negative comments posted by patients are considered to be more influential by other patients and physicians than those that are satisfactory.ObjectiveThe aim of this study was to analyze negative comments posted online about physicians and to identify possible solutions to improve patient satisfaction, as well as their relationship with physicians.MethodsA Java-based program was developed to collect patient comments on the Good Doctor website, one of the most popular online health communities in China. A total of 3012 negative comments concerning 1029 physicians (mean 2.93 [SD 4.14]) from 5 highly ranked hospitals in Beijing were extracted for content analysis. An initial coding framework was constructed with 2 research assistants involved in the codification.ResultsAnalysis, based on the collected 3012 negative comments, revealed that unhappy patients are not alike and that their complaints cover a wide range of issues experienced throughout the whole process of medical consultation. Among them, physicians in Obstetrics and Gynecology (606/3012, 20.12%; P=.001) and Internal Medicine (487/3012, 16.17%; P=.80) received the most negative comments. For negative comments per physician, Dermatology and Sexually Transmitted Diseases (mean 5.72, P<.001) and Andrology (mean 5, P=.02) ranked the highest. Complaints relating to insufficient medical consultation duration (577/3012, 19.16%), physician impatience (527/3012, 17.50%), and perceived poor therapeutic effect (370/3012, 12.28%) received the highest number of negative comments. Specific groups of people, such as those accompanying older patients or children, traveling patients, or very important person registrants, were shown to demonstrate little tolerance for poor medical service.ConclusionsAnalysis of online patient complaints provides an innovative approach to understand factors associated with patient dissatisfaction. The outcomes of this study could be of benefit to hospitals or physicians seeking to improve their delivery of patient-centered services. Patients are expected to be more understanding of overloaded physicians’ workloads, which are impacted by China’s stretched medical resources, as efforts are made to build more harmonious physician-patient relationships.

The Antecedents of Poor Doctor-Patient Relationship in Mobile Consultation: A Perspective from Computer-Mediated Communication

“…To analyze the text-based communication records, qualitative analysis is considered appropriate [12,14,41,49,50]. Specifically, using netnography and coding skills from the qualitative analysis [51], the qualitative data analysis proceeded in the following four steps.…”

“…First, inappropriate information providing, information interpreting and relationship maintaining behaviors of doctors and users are the direct causes of poor DPR in mobile consultation. From the perspective of users, mobile technologies have the potential to empower users with more medical knowledge and greater decision power over their health conditions [12]. However, their doctors fail to provide adequate support to realize the potential, which leads to user dissatisfaction and poor DPR.…”

“…Our findings have the following three theoretical implications: First, this study extends existing studies on poor DPR by integrating both doctors' and users' perspectives. The majority of existing studies tend to investigate DPR only from users' perspectives, such as Um et al (2018) [8] and [12], ignoring the significance of interpreting DPR from dual perspectives of users and doctors. Mobile consultation transforms the traditional doctor-dominated relationship to a more equal and reciprocal relationship [36,54], which emphasizes the importance of taking doctors' experience into account to understand DPR.…”

“…The negative experience is also worth noting because understanding the complaints guide practitioners to improve service quality [8]. Although a few studies have paid attention to the dissatisfying experience of mobile healthcare services, they tend to interpret the experience only from the perspective of users [8,12]. While these studies are insightful, a single perspective from users is not adequate, because they missed the perception of doctors which is considered quite different from that of users [13,14].These two literature gaps (namely lacking studies on dissatisfying experience of mobile healthcare services and lacking dual perspectives from both users and doctors) might partly be attributed to the mainstream research method in the healthcare field.…”

How Health Communication via Tik Tok Makes a Difference: A Content Analysis of Tik Tok Accounts Run by Chinese Provincial Health Committees

“…In the healthcare sector, the adoption of social media is not new [10,11]. Social media has been widely adopted by patients, care-givers, and healthcare professionals, with numerous studies reporting its usefulness in patient empowerment, health promotion, patient-physician relationship building, public health surveillance, and quality improvement [12][13][14][15][16][17]. On the contrary, other studies have focused on revealing the dark side of social media in healthcare; for example, examining how unverified content leads to the sharing of misleading information [18], patients becoming overconfident in their own medical decision making [19,20], and privacy violation [18,21].…”