Inconsistent consultant websites could try patients' patience

A study that evaluated the websites relating to individual consultant orthopaedic surgeons found that half of them failed to provide information about patient satisfaction or the surgeon's involvement in teaching or research, while less than 3% presented mortality rates and none gave an indication of morbidity rates. Researchers identified a need for greater standardisation of the information available to patients online to help them make choices about their healthcare.

The findings come as the National Health Service's 'Choose and Book' online scheme, which allows patients to select the location and time of hospital appointments, has been extended to include the option for patients to select a specific consultant to carry out any necessary treatment. The aim of the study was to examine whether the information available online was comprehensive enough for patients to make an informed decision of who they would like to treat them.

The research, published online today in BMJ Open (the British Medical Journal's open access publication), was undertaken by Northumbria academics Dr Nick Caplan and Professor Alan St Clair Gibson, working with orthopaedic experts from Queen Elizabeth Hospital, Gateshead, and the Chelsea and Westminster Hospital, London.

In the study, which is the first comprehensive analysis of the availability of web-based information relating to consultant surgeons in any field of medicine, the websites of 200 consultant orthopaedic surgeons across the north of England were evaluated using a bespoke template that took into account recommendations of the 2010 UK Government white paper about the information that patients should have access to.

Researchers found that although the majority of the websites were accessible, there were questions around who had written the information and how frequently the information had been updated. Only a small number of websites reported death rate and none reported morbidity rates -- the incidence of complications related to orthopaedic procedures.

Only half of the websites analysed gave any indication of whether the surgeon was involved in teaching-related activities. Previous studies have indicated that some patients would not want to be referred to a teaching consultant as any treatment or procedure may be carried out by a junior clinician under the consultant's supervision. On the other hand, there is evidence that consultants involved in teaching are more likely to remain up-to-date with current medical knowledge.

About half of the websites provided details of any research the consultant had been or was currently engaged in. Involvement in research would indicate to patients that the consultant was keeping up-to-date with new medical knowledge and advances, thus ensuring the best possible, available treatment.

Just under half of the websites did not publish any information on patient satisfaction with the care they had received.

Dr Caplan said: "Despite the government policy encouraging patients to make more choices in relation to healthcare, our findings demonstrate that there is a paucity of data available to patients through online media to allow them to make informed choices about which consultant they wish to be referred to.

"Doctors and healthcare providers need to ensure that sufficient information is available online and these findings highlight the need to standardise websites that provide information about consultants to patients, or indeed, the creation of a centralised online tool that patients can use to access all the required information about available consultants."

The researchers hope to use their evaluation tool to analyse websites in other fields of medicine and across a wider geographic area.

Prof Kader, a consultant orthopaedic surgeon at the Queen Elizabeth Hospital, Gateshead, and co-author of the paper, said: "This research has confirmed what we have heard from patients that the information simply is not there to help them choose who they will receive their treatment from.

"In areas such as insurance and holidays, there is a vast amount of information available on the internet to improve consumers' choice, yet this is not the case for people wanting to make informed choices about their healthcare. This is a significant issue which I have experienced both as a surgeon and as a patient."

Based on the research findings, a new website called www.choosemydoctor.co.uk will soon be launched in an attempt to address the lack of consistency in the availability of information about consultants. The website will be free for the general public to access. Initially presenting information about consultant surgeons practising in the north east of England, the site allows consultants to provide accurate information about themselves, the place they work and their treatment outcomes. The website also allows patients to rate their consultants and write reviews on the treatment they received.

Victoria Harding, the website manager, said: "The launch of the website represents a significant move in the right direction in providing sufficient information to patients so they can make informed choices about their care. This research illustrates the historical lack of information available to patients about consultant surgeons that we hope the website will begin to provide."