Gender Biases in Online Physician Ratings: Female Doctors Evaluated More Harshly by Patients (Preprint)

BACKGROUND Prior research has highlighted gender differences in online physician reviews, however, to date no research has linked online ratings with quality of care. OBJECTIVE To compare a consumer-generated measure of physician quality (online ratings) with a clinical quality outcome (sanctions for malpractice or improper behavior), to understand how patients’ perception and evaluation of doctors differ based on the physician’s gender and quality. METHODS We use data from a large online doctor reviews website and the Federation of State Medical Boards. We implement paragraph vector methods to identify words that are specific to and indicative of the separate groups of physicians. We then enrich these findings by utilizing the NRC word-emotion association lexicon to assign emotional scores to the various segments: gender, gender and sanction, and gender and rating. RESULTS We find significant differences in the sentiment and emotion of reviews for male and female physicians. We find that numerical ratings are lower and the sentiment in text reviews is more negative for women who will be sanctioned than for men who will be sanctioned; sanctioned male doctors are still associated with positive reviews. CONCLUSIONS Conclusions: Given the growing impact of online reviews on demand for physician services, understanding the different reviews faced by male and female physicians is important for consumers and for platform architects in order to revisit their platform design.

FACTORS THAT INFLUENCE PATIENTS’ RECOMMENDATION OF ORTHOPAEDIC SURGEONS: AN ANALYSIS OF A POPULAR ONLINE RATING WEBSITE

Background: In the modern digital age, patients are increasingly consulting online physician reviews prior to making healthcare decisions. Physician review websites are being used in many medical fields including orthopaedic surgery. The purpose of this study is to investigate trends in online physician reviews and determine which factors are most strongly correlated with the likelihood that an orthopaedic surgeon is to be recommended by patients. Methods: Healthgrades.com, the most comprehensive physician rating and comparison database, was queried for “orthopaedic surgery” in the state of New Jersey. Demographic information, fellowship training status, years of experience, malpractice/disciplinary actions, physician ratings and the likelihood to recommend score (LTRS) was collected for all physicians. Quantitative analysis was conducted using descriptive statistics, student t-test, and one-way ANOVA. Qualitative analysis of randomly selected positive comments and all negative comments was conducted. Common themes were identified using frequency-based word cloud generator. Results: 834 board certified orthopaedic surgeons (800 Males, 34 Females), with a mean age of 55.7±12.5 years and an average LTRS of 4.1±0.84 were included for analysis. Compared with non-fellowship trained orthopaedic surgeons, fellowship trained surgeons were more likely to be recommend by patients [3.8 vs. 4.3; P< 0.0001]. Physicians with waiting time <10min were more likely to be recommended compared with their counterparts with waiting time >10min (P< 0.0001). No differences were observed in LTRS between male and female orthopaedic surgeons (P= 0.79) or based on malpractice status (P= 0.61). Qualitative analysis of a randomly selected sample of 4,151 out of a total of 12,168 positive comments and 1,113 total negative comments revealed that positive comments centered on surgeon competence and professionalism, while negative comments centered on surgeon personality and waiting time. Conclusion: Orthopaedic surgeons have generally favorable ratings and mostly positive comments. Fellowship status and waiting time are important factors that impact LTRS. Patients were more likely to write positive comments about surgeon competence and professionalism, and negative comments pertaining to surgeon personality and waiting time. Knowledge of surgeon specific attributes that are important to patients may help educate orthopaedic surgeons to improve patient care, patient satisfaction and online ratings. Tables and Figures [Table: see text][Table: see text][Figure: see text]

Influencing factors and mechanism of doctor consultation volume on online medical consultation platforms based on physician review analysis

PurposeThis paper aims to reveal the factors patients consider when choosing a doctor for consultation on an online medical consultation (OMC) platform and how these factors influence doctors' consultation volumes.Design/methodology/approachIn Study 1, influencing factors reflected as service features were identified by applying a feature extraction method to physician reviews, and the importance of each feature was determined based on word frequencies and the PageRank algorithm. Sentiment analysis was used to analyze patient satisfaction with each service feature. In Study 2, regression models were used to analyze the relationships between the service features obtained from Study 1 and the doctor's consultation volume.FindingsThe study identified 14 service features of patients' concerns and found that patients mostly care about features such as trust, phraseology, overall service experience, word of mouth and personality traits, all of which describe a doctor's soft skills. These service features affect patients' trust in doctors, which, in turn, affects doctors' consultation volumes.Originality/valueThis research is important as it informs doctors about the features they should improve, to increase their consultation volume on OMC platforms. Furthermore, it not only enriches current trust-related research in the field of OMC, which has a certain reference significance for subsequent research on establishing trust in online doctor–patient relationships, but it also provides a reference for research concerning the antecedents of trust in general.

Gender, Soft Skills, and Patient Experience in Online Physician Reviews: A Large-Scale Text Analysis

Background Online physician reviews are an important source of information for prospective patients. In addition, they represent an untapped resource for studying the effects of gender on the doctor-patient relationship. Understanding gender differences in online reviews is important because it may impact the value of those reviews to patients. Documenting gender differences in patient experience may also help to improve the doctor-patient relationship. This is the first large-scale study of physician reviews to extensively investigate gender bias in online reviews or offer recommendations for improvements to online review systems to correct for gender bias and aid patients in selecting a physician. Objective This study examines 154,305 reviews from across the United States for all medical specialties. Our analysis includes a qualitative and quantitative examination of review content and physician rating with regard to doctor and reviewer gender. Methods A total of 154,305 reviews were sampled from Google Place reviews. Reviewer and doctor gender were inferred from names. Reviews were coded for overall patient experience (negative or positive) by collapsing a 5-star scale and coded for general categories (process, positive/negative soft skills), which were further subdivided into themes. Computational text processing methods were employed to apply this codebook to the entire data set, rendering it tractable to quantitative methods. Specifically, we estimated binary regression models to examine relationships between physician rating, patient experience themes, physician gender, and reviewer gender). Results Female reviewers wrote 60% more reviews than men. Male reviewers were more likely to give negative reviews (odds ratio [OR] 1.15, 95% CI 1.10-1.19; P<.001). Reviews of female physicians were considerably more negative than those of male physicians (OR 1.99, 95% CI 1.94-2.14; P<.001). Soft skills were more likely to be mentioned in the reviews written by female reviewers and about female physicians. Negative reviews of female doctors were more likely to mention candor (OR 1.61, 95% CI 1.42-1.82; P<.001) and amicability (OR 1.63, 95% CI 1.47-1.90; P<.001). Disrespect was associated with both female physicians (OR 1.42, 95% CI 1.35-1.51; P<.001) and female reviewers (OR 1.27, 95% CI 1.19-1.35; P<.001). Female patients were less likely to report disrespect from female doctors than expected from the base ORs (OR 1.19, 95% CI 1.04-1.32; P=.008), but this effect overrode only the effect for female reviewers. Conclusions This work reinforces findings in the extensive literature on gender differences and gender bias in patient-physician interaction. Its novel contribution lies in highlighting gender differences in online reviews. These reviews inform patients’ choice of doctor and thus affect both patients and physicians. The evidence of gender bias documented here suggests review sites may be improved by providing information about gender differences, controlling for gender when presenting composite ratings for physicians, and helping users write less biased reviews.

Influence of Health Literacy on Effects of Patient Rating Websites: Survey Study Using a Hypothetical Situation and Fictitious Doctors

Background Physician rating websites (PRWs) are a device people use actively and passively, although their objective capabilities are insufficient when it comes to judging the medical performance and qualification of physicians. PRWs are an innovation born of the potential of the Internet and boosted very much by the longstanding policy of improving and encouraging patient participation in medical decision-making. A mismatch is feared between patient motivations to participate and their capabilities of doing so well. Awareness of such a mismatch might contribute to some skepticism of patient-written physician reviews on PRWs. Objective We intend to test whether health literacy is able to dampen the effects that a patient-written review of a physician’s performance might have on physician choice. Methods An experiment was conducted within a survey interview. Participants were put into a fictitious decision situation in which they had to choose between two physicians on the basis of their profiles on a PRW. One of the physician profiles contained the experimental stimulus in the form of a friendly and a critical written review. The dependent variable was physician choice. An attitude differential, trust differential, and two measures of health literacy, the newest vital sign as an example of a performance-based measure and eHealth Literacy Scale as an example of a perception-based measure, were tested for roles as intermediary variables. Analysis traced the influence of the review tendency on the dependent variables and a possible moderating effect of health literacy on these influences. Results Reviews of a physician’s competence and medical skill affected participant choice of a physician. High health literacy dampened these effects only in the case of the perception-based measure and only for the negative review. Correspondingly, the effect of the review tendency appeared to be stronger for the positive review. Attitudes and trust only affected physician choice when included as covariants, considerably increasing the variance explained by regression models. Conclusions Findings sustain physician worries that even one negative PRW review can affect patient choice and damage doctors’ reputations. Hopes that health literacy might raise awareness of the poor basis of physician reviews and ratings given by patients have some foundation.