‘It took 16 hours’: About half of Google reviews of Canadian hospitals are negative, study finds

Many Canadians have not-so-fond memories of their hospital experiences, suggests a new study that found nearly half of online hospital reviews analyzed involved negative feedback.

A random sample of 1,000 Google review comments involving Canadian acute care hospitals from 2017 to 2022 found people were more likely to leave negative (47.9 per cent) than mixed (19.8 per cent) or positive (32.3 per cent) reviews.

Feedback ranged from “the most frustrating experience in my life” to “great care and attentive physicians and staff.”

Senior author Dr. Dhruv Nayyar cautioned it’s not a fully representative sample of the patients treated in hospitals. People with a negative experience are also more likely to leave an online review, he said. “I would be careful before we make any conclusions that that means half of patients have a really negative experience,” said Nayyar, an internal medicine physician at St. Michael’s Hospital in Toronto.

“Other data sources say that the majority of patients do have a positive experience with their care.”

However, “I think it tells us patients who have a negative experience are motivated to talk about it — that they want to have their voices heard,” he said.

“A negative experience on one of the most vulnerable days of their life when they’re seeking care in a hospital is something that can be very traumatic and can, unfortunately, be a very lasting memory that can stick with people for a very long time.”

A better experience leads to better and safer care, he added. Three-quarters of the reviews were “actionable,” he said, meaning they could be used to meaningfully improve care on the ground.

“Most reviews (74 per cent) were semi-actionable or very actionable,” Nayyar and his colleagues report in the journal, BMJ Open Quality.

Traditional, standardized patient surveys have their problems, the authors wrote, including that they’re infrequently collected and reported and have low, and falling, response rates.

An unsolicited Google review is “carte blanche,” said Nayyar, a quality improvement researcher with the University of Toronto. “‘Tell us what was salient and meaningful to you about your experience'” as opposed to a formal survey with pre-set questions.

For their study, the authors downloaded Google reviews star ratings and text comments for all Canadian acute care hospitals from 2014 to 2022.

Each review publishes the person’s name and must have a valid accompanying email address, they noted. Google also limits reviews to one review per hospital per email address.

Text comments had to meet a minimum word count (those with fewer than five words were excluded).

From just over 53,000 total reviews extracted, the team analyzed a random sample of 1,000.

The proportion of negative reviews increased from 45.7 per cent in the 2017-2019 time period, to 50.1 per cent in the 2020-2022 stretch.

Positive reviews also increased — from 30.4 per cent to 34.2.

Wait times were mentioned in half of the negative reviews.

About a third mentioned interactions with doctors (33.3 per cent), nurses (32.7 per cent) or “unspecified” staff (33 per cent).

One negative comment reads: “Extremely rude staff. Spend (sic) over 12 hours without seeing a single doctor. After 14 hours, ask for pain killers, nurse ignored and rudely told me to exit the room and to wait my turn. Doctors called a single patient in every 45 minutes to an hour.”

“My grandmother broke her hip and it took 16 hours for them to decide which ward she should go to so she could finally sleep somewhere quiet instead of an emergency room,” another user commented.

One parent described the ordeal their daughter experienced getting gallbladder surgery. “Had a surgery lined up (in city A), we are from (city B) … got to (city A) at 7 am. They took her into day op, prepped her … she came to find me 10 minutes later, they forgot to give a test before the operation. While on the operating room table (the doctor) cancelled my daughter’s surgery… they told us after cancelling our appointment now for the 5th time they don’t have room in ICU for her …surgery is now rescheduled for a month and a half later … if she didn’t need it so badly, I would start the process all over somewhere else.”

Mixed comments included people describing “excellent care” despite “abysmal” crowding. The more complimentary praised “friendly, efficient and competent” staff.

The text comments were analyzed for their ability to lead to clear, practical steps, Nayyar said. “‘This place was no good,’ or, ‘Hey, I had a great experience,’ it’s hard to do much with that,” he said.

Other times, people leave specific reviews “about exactly what happened to them. They’ll tell you, ‘I was in this part of the hospital, I was in the emergency department. It was loud; there were issues with cleanliness. I was waiting a long time to be seen, I was in pain.'”

“We did see comments, for sure, from patients who found their care was efficient, timely. That things happened quickly. It’s important for hospitals to see those signals, too. When things are working well and working efficiently, patients appreciate it.”

The study has limitations, including selection bias, meaning people with lower digital literacy, older people, people who don’t speak English or are marginalized with lower income are underrepresented in a data source like Google reviews, Nayyar said.

“That being said, there is a wealth of useful information in these reviews.”

A study released in July by the public policy think tank SecondStreet.org based on nearly 9,000 Google review scores for 84 major Canadian hospitals found an average score of 2.88 out of five in 2025, down slightly from 2.91 in 2024.

Provincial averages ranged from a low of 2.401 in New Brunswick, to a high of 3.061 in British Columbia.

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