Background: Physician-rating websites (PRWs) are designed to publicly report physician quality information while bringing forth a sense of transparency. This study looks to identify the influence PRWs have on a patient’s choice of orthopedic hand surgeon while stratifying patient physician preference by various demographic characteristics. Methods: This survey-based study was conducted in a suburban outpatient orthopedic hand practice. All patients between 18 to 89 years of age who presented for an appointment were asked to participate. Survey questions aimed to identify patient demographics and the sources patients used to choose their hand surgeon. Results: Overall, 104 patients completed our survey. Our study population was predominantly between 51 and 70 years of age (50.0%), women (60.6%), and Caucasian (84.6%), received a general education degree or high school diploma (36.5%), was employed (49.0%), and owned private health insurance (59.6%). One hundred and two patients (98.1%) answered that their physician’s reputation is important. Seventy-five patients (72.1%) reported that they heard about their surgeon by physician referral, while only two (1.9%) used online search engines. Sixty-six patients (63.5%) noted that physician referrals were most trustworthy. Only 10 patients (9.6%) consulted PRWs to choose their surgeon, most of whom were younger than 50 years (n = 6), Caucasian (n = 8), and employed (n = 7) and had schooling after high school (n = 8). Conclusions Despite increases in digital information exchange platforms, PRWs are not commonly used by suburban orthopedic hand patients to exchange information about or choose their hand surgeon. Patients still primarily rely on physician referrals and word of mouth from family and friends to choose their surgeon.

BACKGROUND: Previous studies have reported what patients value while choosing their surgeon, but there are no studies exploring the patterns of referral to spine surgeons among primary care physicians (PCPs). This study aims to identify any trends in PCPs' referral to orthopedic surgery versus neurosurgery for spinal pathology. METHODS: In total, 450 internal medicine, family medicine, emergency medicine, neurology, and pain management physicians who practice at one of three locations (suburban community hospital, urban academic university hospital, and urban private practice) were asked to participate in the study. Consenting physicians completed our 24-question survey addressing their beliefs according to pathologies, locations of pathologies, and surgical interventions. RESULTS: Overall, 108 physicians (24%) completed our survey. Fifty-seven physicians (52.8%) felt that neurosurgeons would provide better long-term comprehensive spinal care. Overall, 66.7% of physicians would refer to neurosurgery for cervical spine radiculopathy; 52.8%, to neurosurgery for thoracic spine radiculopathy; and 56.5%, to orthopedics for lumbar spine radiculopathy. Most physicians would refer all spine fractures to orthopedics for treatment except cervical spine fractures (56.5% to neurosurgeons). Most physicians would refer to neurosurgery for extradural tumors (91.7%) and intradural tumors (96.3%). Most would refer to orthopedic surgeons for chronic pain. Finally, physicians would refer to orthopedics for spine fusion (61.1%) and discectomy (58.3%) and to neurosurgery for minimally invasive surgery (59.3%). CONCLUSIONS Even though both orthopedic surgeons and neurosurgeons are intensively trained to treat a similar breath of spinal pathology, physicians vary in their referring patterns according to spinal pathology, location of pathology, and intended surgery. Education on the role of spine surgeons among PCPs is essential in ensuring unbiased referral patterns.