Developments in the Frequency of Ratings and Evaluation Tendencies: A Review of German Physician Rating Websites

Background: Physician rating websites (PRWs) have been developed to allow all patients to rate, comment, and discuss physicians’ quality online as a source of information for others searching for a physician. At the beginning of 2010, a sample of 298 randomly selected physicians from the physician associations in Hamburg and Thuringia were searched for on 6 German PRWs to examine the frequency of ratings and evaluation tendencies. Objective: The objective of this study was to examine (1) the number of identifiable physicians on German PRWs; (2) the number of rated physicians on German PRWs; (3) the average and maximum number of ratings per physician on German PRWs; (4) the average rating on German PRWs; (5) the website visitor ranking positions of German PRWs; and (6) how these data compare with 2010 results. Methods: A random stratified sample of 298 selected physicians from the physician associations in Hamburg and Thuringia was generated. Every selected physician was searched for on the 6 PRWs (Jameda, Imedo, Docinsider, Esando, Topmedic, and Medführer) used in the 2010 study and a PRW, Arztnavigator, launched by Allgemeine Ortskrankenkasse (AOK). Results: The results were as follows: (1) Between 65.1% (194/298) on Imedo to 94.6% (282/298) on AOK-Arztnavigator of the physicians were identified on the selected PRWs. (2) Between 16.4% (49/298) on Esando to 83.2% (248/298) on Jameda of the sample had been rated at least once. (3) The average number of ratings per physician ranged from 1.2 (Esando) to 7.5 (AOK-Arztnavigator). The maximum number of ratings per physician ranged from 3 (Esando) to 115 (Docinsider), indicating an increase compared with the ratings of 2 to 27 in the 2010 study sample. (4) The average converted standardized rating (1=positive, 2=neutral, and 3=negative) ranged from 1.0 (Medführer) to 1.2 (Jameda and Topmedic). (5) Only Jameda (position 317) and Medführer (position 9796) were placed among the top 10,000 visited websites in Germany. Conclusions: Whereas there has been an overall increase in the number of ratings when summing up ratings from all 7 analyzed German PRWs, this represents an average addition of only 4 new ratings per physician in a year. The increase has also not been even across the PRWs, and it would be advisable for the users of PRWs to utilize a number of PRWs to ascertain the rating of any given physician. Further research is needed to identify barriers for patients to rate their physicians and to assist efforts to increase the number of ratings on PRWs to consequently improve the fairness and practical importance of PRWs

Zum Einfluss der Elternschaft auf die Karriereorientierung von Ärztinnen: eine Fallrekonstruktion

"Ziel: Anhand einer detaillierten Fallbeschreibung werden karriereförderliche- und hinderliche Bedingungen auf subjektiver und Paarebene rekonstruiert, denen Ärztinnen durch das kritische Lebensereignis Elternschaft ausgesetzt werden können. Um Aussagen struktureller Art treffen zu können, werden diesem Paar weitere Paare in minimalem und maximalem Kontrast dazugestellt, die in einem längsschnittlichen Design über vier bis sechs Jahre mindestens drei Mal interviewt wurden. Ergebnisse: Trotz egalitärer Rollenvorstellungen der Paare vor einer Schwangerschaft kann es zu Traditionalisierungseffekten durch den Übergang in eine Triade kommen, wobei Sozialisationserfahrungen aus der Ursprungsfamilie bedeutsam sind. Konflikte entstehen dann, wenn die Lebensbereiche Beruf und Familie für karriereorientierte Ärztinnen durch eine Elternschaft nicht an Bedeutung verlieren, sondern sie beides gleichzeitig wollen. Die damit verbundenen Anforderungen einlösen zu können, erfordert gerade auf Seiten der Frau ein hohes Maß an Organisation und Arrangement. Diskussion: Neben arbeitsstrukturellen und -organisatorischen Bedingungen und Strukturgebern, müssen individuelle Bedarfe der Ärztinnen in den Blick genommen werden, um beide Lebensbereiche zufriedenstellend ausfüllen zu können." (Autorenreferat)"Aim: In order to find conditions that may promote or constrain the career of women doctors, we conducted longitudinal interviews with dualcareer couples over a period of four to six years. Based on content analysis, we identified one couple for detailed analysis. For minimally and maximally contrasting these couples, we complemented our analysis by including additional couples for gaining more structured insights. Results: Despite egalitarian role concepts prior to pregnancy, it is through the transition into a triad that effects of traditionalism emerge for which, in turn, socialization effects from the family of origin are meaningful. Conflicts do arise when both the areas of professional and family life do not lose their relevance after entering parenthood. It requires a high degree of management for getting things organized, especially on the part of the women. Discussion: In addition to important structural and organizational working conditions that serve as important providers of structure, individual needs of women doctors have to be taken into account for enabling women doctors to perform satisfactorily in both areas of life." (author's abstract

„Also, ich weiß nicht, ob ich da hin will“ : Die Rekonstruktion geschlechtsspezifischer beruflicher (Karriere-)Orientierung und Sozialisation von Ärztinnen und Ärzten in Weiterbildung

Trotz annähernd gleicher Anzahl von Ärztinnen und Ärzten im Beruf bekleiden nur wenige Ärztinnen Führungspositionen. Historisch betrachtet ist die nominale Feminisierung des ärztlichen Berufs noch jung und das Krankenhaus kann auch heute noch als ein typischer Vertreter einer „gendered organization“ (Acker 1990) bezeichnet werden, deren Imperative einer idealen ärztlichen Tätigkeit und Führung mit männlichem Geschlecht assoziiert sind. Die normativen Leitbilder vermitteln sich implizit im Verlauf der Identifizierung mit der Arztrolle. Anhand von Gruppendiskussionen zeigen wir, mit welchen strukturellen und informellen Lehrplänen Ärztinnen und Ärzte in ihrer fachärztlichen Weiterbildung konfrontiert werden. Dabei sind Anforderungen an die Verausgabung für die Tätigkeit, Subjektivierungstendenzen, Führung und Macht sowie die Definition von Leistung zentrale und besonders eng mit Geschlecht assoziierte Sozialisationsinstitutionen. Auch wenn vordergründig geschlechtsspezifische Motivlagen für die Unterschiede verantwortlich gemacht werden, zeigen wir, dass es sich dabei um zustimmende Anpassungsleistungen an strukturelle Bedingungen ärztlicher Tätigkeit handelt.„Well, I do not know if I want to“ The reconstruction of gender socialization of doctors in training Abstract: Despite approximately equal distribution of male and female physicians in occu- pations, only a few female doctors occupy leadership positions. Historically, the nominal feminization of the medical profession is still young and the hospital can still be regarded as a typical representative of a “gendered organization” (Acker 1990) which is identified among others by imperatives of an ideal medical practice and guidance associated with male gender. The normative models convey implicitly in the course of identification with the doctor role. Using focus groups, we show what structural and informal curricula physicians are confron- ted with in their training course. Requirements for the expenditure for the job, tendencies of subjectivation of employment, leadership and power and the definition of performance are central socialization institutions and strongly associated with gender. Although ostensibly gender typical motivations are made responsible, we show that these are favorable adjust- ments to structural conditions of medical practice

The representation of patient experience and satisfaction in physician rating sites. A criteria-based analysis of English- and German-language sites

<p>Abstract</p> <p>Background</p> <p>Information on patient experience and satisfaction with individual physicians could play an important role for performance measures, improved health care and health literacy. Physician rating sites (PRSs) bear the potential to be a widely available source for this kind of information. However, patient experience and satisfaction are complex constructs operationalized by multiple dimensions. The way in which PRSs allow users to express and rate patient experience and satisfaction could likely influence the image of doctors in society and the self-understanding of both doctors and patients. This study examines the extent to which PRSs currently represent the constructs of patient experience and satisfaction.</p> <p>Methods</p> <p>First, a systematic review of research instruments for measuring patient experience and satisfaction was conducted. The content of these instruments was analyzed qualitatively to create a comprehensive set of dimensions for patient experience and patient satisfaction. Second, PRSs were searched for systematically in English-language and German-language search engines of Google and Yahoo. Finally, we classified every structured question asked by the different PRS using the set of dimensions of patient experience and satisfaction.</p> <p>Results</p> <p>The qualitative content analysis of the measurement instruments produced 13 dimensions of patient experience and satisfaction. We identified a total of 21 PRSs. No PRSs represented all 13 dimensions of patient satisfaction and experience with its structured questions. The 3 most trafficked English-language PRS represent between 5 and 6 dimensions and the 3 most trafficked German language PRSs between 8 and 11 dimensions The dimensions for patient experience and satisfaction most frequently represented in PRSs included diversely operationalized ones such as <it>professional competence </it>and <it>doctor-patient relationship/support</it>. However, other less complex but nevertheless important dimensions such as <it>communication skills </it>and <it>information/advice </it>were rarely represented, especially in English-language PRSs.</p> <p>Conclusions</p> <p>Concerning the potential impact of PRSs on health systems, further research is needed to show which of the current operationalizations of patient experience and satisfaction presented in our study are establishing themselves in PRSs. Independently of this factual development, the question also arises whether and to what extent health policy can and should influence the operationalization of patient experience and satisfaction in PRSs. Here, the challenge would be to produce a set of dimensions capable of consensus from among the wide range of operationalizations found by this study.</p

"Was, wie, ich?" - "Ja, doch, du!" Prozesse von Schließung, Hierarchisierung und Öffnung in den akademischen Karrieren von Informatik-Doktorandinnen

Mit zunehmender akademischer Karrierestufe sinkt der Anteil von Frauen im Bereich der Informatik. Wir fragen nach möglichen Zugängen von Frauen zum Studium und zur Promotion in der Informatik sowie nach Bedingungen der beruflichen Sozialisation. Es wurden 14 teilstrukturierte Interviews mit IT-Promovendinnen durchgeführt. Anhand von Erzählungen und Beschreibungen wurden förderliche und hinderliche Bedingungen als strukturelle Öffnungen, Schließungen und Hierarchisierungen identifiziert. Hierarchisierungen finden sich u. a. in der geschlechterbezogenen Zuteilung und Übernahme von Arbeitstätigkeiten. Trotz der Wahrnehmung von Geschlechtergerechtigkeit sind die Zugänge zu einer männlich dominierten Disziplin strukturell reglementiert. Öffnungsprozesse jedoch weisen auf Möglichkeiten des Vergessens von Geschlecht und in der Folge auch auf Möglichkeiten der strukturellen Durchsetzung von Gleichberechtigung hin.The proportion of women in the computer sciences declines the higher up the career ladder they progress. We investigate possible access routes for women into university studies and doctorates and the conditions for their professional socialization. Fourteen semi-structured interviews were conducted with female computer science PhD students. Based on narratives and descriptions, conducive and obstructive conditions were identified as structural openings, closures and hierarchies. Hierarchies can be found, among other things, in the gender-based allocation and acceptance of work activities. Despite the general recognition of gender justice, access to a male-dominated discipline is structurally regulated. Processes of opening up, however, point to the possibility that gender can be forgotten and, in consequence, to the possibility of equality being structurally implemented