title: General Practitioners' Concerns About Online Patient Feedback: Findings From a Descriptive Exploratory Qualitative Study in England.
abstract: BACKGROUND
  The 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.
  
  
  OBJECTIVE
  The 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.
  
  
  METHODS
  A 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.
  
  
  RESULTS
  Most 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.
  
  
  CONCLUSIONS
  The 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.
authors.affiliation: WMG, University of Warwick, Coventry, United Kingdom. salma.patel@warwick.ac.uk.
authors.forename: Salma
authors.identifier: http://orcid.org/0000-0002-6058-8382
authors.initials: S
authors.lastname: Patel
authors.forename: Rebecca
authors.identifier: http://orcid.org/0000-0001-9453-0667
authors.initials: R
authors.lastname: Cain
authors.forename: Kevin
authors.identifier: http://orcid.org/0000-0001-5720-5005
authors.initials: K
authors.lastname: Neailey
authors.forename: Lucy
authors.identifier: http://orcid.org/0000-0003-1407-5823
authors.initials: L
authors.lastname: Hooberman
mesh_terms: D000368:Aged; D001291:Attitude of Health Personnel; D004739:England; D005246:Feedback; D005260:Female; D058005:General Practitioners / Q000592:standards*; D006801:Humans; D008297:Male; D008875:Middle Aged; D036301:Qualitative Research; D017216:Telemedicine / Q000706:statistics & numerical data*
keywords: Internet; attitude of health personnel; delivery of health care; feedback; online reviews; patient empowerment; physician quality; primary care; public reporting; quality; quality transparency