PURPOSE To determine the impact of social media content from oculoplastic surgeon-held accounts on public engagement. METHODS This study analyzed successful Instagram accounts (defined by >500 followers as of May 2019) held by American Society of Ophthalmic Plastic Reconstruction Surgery members. Each account's 20 most and 20 least successful posts (based on number of likes) were characterized by the post's subject, location, media type, and tag usage. Posts were then analyzed using a web-based application that calculates the engagement level of Instagram users with the selected post. RESULTS A total of 4,812 posts were analyzed from 37 Instagram accounts. Of these American Society of Ophthalmic Plastic Reconstruction Surgery members, the majority were men (67.6%, n = 25) in private practice solely (70.3%, n = 26). Numerous post characteristics, like content and media type, impacted success in a statistically significant manner; for example, public engagement rose when featuring the posting doctor, especially when smiling and wearing a white coat. Meanwhile, posts featuring an office procedure had a negative effect. Formatting was also found to contribute to success. For example, photographs were preferred over videos, while multiple images were best presented sequentially as a carousel (with the viewer swiping through the series) rather than in a large collage. Use of tags (hashtags, accounts, and locations) were associated with increased engagement. CONCLUSIONS Social media is an important communication and marketing tool, especially in esthetic fields like oculoplastics. Guidelines for success are presented in this study; content, location, subject, media type, and tags statistically significantly impact public engagement.The influence of social media is rapidly growing and can be strategically harnessed by oculoplastic surgeons to educate both patients and healthcare providers, collaborate with colleagues, and for referrals and marketing.Supplemental Digital Content is available in the text.

Building Your Brand: Analysis of Successful Oculoplastic Surgeons on Social Media.

Purpose: To determine what metrics might impact satisfaction survey responses.Methods: A 37-question survey was administered to 249 participants. Responses were correlated to demographics, clinical...

Factors Associated with Patient Satisfaction in an Outpatient Glaucoma Population.

The purpose of the current study is to examine how nonmodifiable sociodemographic, disease, appointment, management, and survey factors correlate with provider rating. This was a retrospective cross-sectional study conducted on 29 857 patient Clinician and Group Consumer Assessment of Healthcare Providers and Systems surveys collected from January 2017 to January 2019 at a tertiary eye center. We included surveys of patients aged 18 years or older, who answered at least 4 of 6 subfield questions, and completed the survey within 90 days of the appointment. The main outcome was the odds of receiving top box score (TBS) of 10/10 on the survey question regarding overall provider rating. The results showed that the variables with higher odds of TBS included higher overall appointment attendance (odds ratio [OR]: 2.66 [95% CI: 1.23-5.75], P = .013); older patient age (OR 2.44 [95% CI: 2.08-2.87], P < .001]; higher percentage of survey questions completed (OR: 2.02 [95% CI: 1.79-2.27], P < .001); better best corrected visual acuity (OR: 1.85 [95% CI: 1.3-2.64], P = .001); optometry clinic visit (OR: 1.25 [95% CI: 1.15-1.36], P < .001); having procedures (OR: 1.19 [95% CI: 1.04-1.36], P = .013), surgery scheduled (OR: 1.18 [95% CI: 1.03-1.36], P = .020], or refraction done (OR: 1.16 [95% CI: 1.08-1.25], P < .001); being seen by male providers (OR: 1.11 [95% CI: 1.04-1.17], P = .001); and having additional eye testing performed (OR: 1.06 [95% CI: 1.00-1.13], P = .048). Variables associated with lower odds of TBS included longer time to complete survey (OR: 0.42 [95% CI: 0.3-0.58], P = .001); new patient encounter (OR: 0.62 [95% CI: 0.58-0.65], P < .001); and glaucoma (OR: 0.66 [95% CI: 0.59-0.75], P < .001), cornea (OR: 0.79 [95% CI: 0.71-0.87], P < .001), or comprehensive clinic visits (OR: 0.86 [95% CI: 0.79-0.94], P < .001). Thus, nonmodifiable factors may affect the provider rating, and these factors should be studied further and accounted for when interpreting the results of patient experience surveys.

Ophthalmology Provider Ratings and Patient, Disease, and Appointment Factors.

Resumen El presente documento tiene por objeto reflexionar sobre algunas circunstancias que dieron origen y perpetuaron la bata blanca como distintivo de la profesión médica, así como para prevenir del riesgo infeccioso que supone la práctica médica, hecho más manifiesto ahora por el advenimiento y globalización de la pandemia por COVID-19, que amenazan su utilización a futuro. El riesgo contaminante y de infección cruzada de la bata blanca se incrementa con el tiempo de uso. Esta cosideraciòn biológica se suma al descrédito social experimentado por la medicina en el marco de los sistemas sanitarios modernos que pretenden cobertura y eficiencia. En la transferencia de esta falta de preeminencia de la profesión a sus símbolos, la bata ha perdido para el imaginario el significado de idoneidad, pulcritud y compasión que se supone que representa. En un marco utilitarista, la bata blanca debería contribuir en la sanación por su efecto simbólico, que supera el riesgo biológico que entraña. Mientras se conciben batas blancas anticontaminantes, sea o no durante crisis sanitarias como las pandemias, los trabajadores de la salud por sus genuinas actitudes, deberían ser vistos “de blanco” ya que, parafraseando, aquellos que las portan, curan y salvan unas cuantas veces, alivian el dolor y el sufrimiento en otro tanto pero, escuchan con compasión, empatía, y acompañan y consuelan siempre (casi sin esperar nada a cambio).

El ocaso de la Bata Blanca: ¿otro efecto de la COVID-19?: The decline of the White Coat: another effect of COVID-19?

Objective The patient–physician relationship impacts patients’ experiences and health outcomes. Physician attire is a form of nonverbal communication that influences this relationship. Prior studies examining attire preferences suffered from heterogeneous measurement and limited context. We thus performed a multicentre, cross-sectional study using a standardised survey instrument to compare patient preferences for physician dress in international settings. Setting 20 hospitals and healthcare practices in Italy, Japan, Switzerland and the USA. Participants Convenience sample of 9171 adult patients receiving care in academic hospitals, general medicine clinics, specialty clinics and ophthalmology practices. Primary and secondary outcome measures The survey was randomised and included photographs of a male or female physician dressed in assorted forms of attire. The primary outcome measure was attire preference, comprised of composite ratings across five domains: how knowledgeable, trustworthy, caring and approachable the physician appeared, and how comfortable the respondent felt. Secondary outcome measures included variation in preferences by country, physician type and respondent characteristics. Results The highest rated forms of attire differed by country, although each most preferred attire with white coat. Low ratings were conferred on attire extremes (casual and business suit). Preferences were more uniform for certain physician types. For example, among all respondents, scrubs garnered the highest rating for emergency department physicians (44.2%) and surgeons (42.4%). However, attire preferences diverged for primary care and hospital physicians. All types of formal attire were more strongly preferred in the USA than elsewhere. Respondent age influenced preferences in Japan and the USA only. Conclusions Patients across a myriad of geographies, settings and demographics harbour specific preferences for physician attire. Some preferences are nearly universal, whereas others vary substantially. As a one-size-fits-all dress policy is unlikely to reflect patient desires and expectations, a tailored approach should be sought that attempts to match attire to clinical context.

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International patient preferences for physician attire: results from cross-sectional studies in four countries across three continents

Importance Interest is growing in targeting physician attire to improve the patient experience. Few studies in ophthalmology have examined patient preferences for physician attire. Objective To understand patient preferences for physician attire in ophthalmology practices in the United States. Design Survey-based, cohort study. Setting Two private and two academic ophthalmology practices. Participants A convenience sample of patients receiving ophthalmic care between June 1, 2015 and October 31, 2016. Methods A questionnaire containing 22 questions and photographs of a male and female physician in seven forms of attire were presented to patients; 14 unique questionnaires were randomly distributed. Patient preference for physician attire was the primary outcome determined by summing ratings of how knowledgeable, trustworthy, caring, approachable, and comfortable the pictured physician made the respondent feel. One-way ANOVA assessed differences in mean composite scores. Comparisons between respondent demographics, practice type, and attire preferences were assessed by chi-square tests. Patient satisfaction was assessed by agreement with questions about importance of physician attire and whether this influences happiness with care. Results In total, 1,297 of 1,826 (71.0%) questionnaires were completed. Physician attire was rated as “important” by 62.9% of participants. A total of 43.6% of participants indicated that physician attire influenced how happy they were with their care. Overall, formal attire with white coat was preferred to casual, formal, and business attire (all comparisons, p  Conclusions Physician attire is important to patients receiving ophthalmic care. Policies aimed at physician attire in ophthalmology practices should be considered.

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Katherine M. Whipple

Papers

Patient Preferences for Physician Attire in Ophthalmology Practices