Bifurcation of Patient Reviews: An Analysis of Trends in Online Ratings

BACKGROUND: Online reviews have become increasingly important drivers of healthcare decisions. Data published by the Pew Research Center from 2016 suggest that 84% of adult Americans use online rating sites to search for information about health issues. The authors sought to analyze physician reviews collected from a large online consumer rating site to better understand characteristics that are associated with positive and negative review behavior. METHODS: Published patient reviews from RealSelf were sampled over a 12-year period (June 2006 to August 2018). SQL, Python, and Python SciPy were used for statistical analysis on 156,965 reviews of 10,376 unique physicians. Python VADER was used to quantify consumer sentiment with review text as input. RESULTS: Surgical procedures tended to be higher rated than nonsurgical treatments. The highest-rated procedures were breast augmentation, rejuvenation of the female genitalia, and facelift. The lowest-rated surgical procedures were buttock augmentation, rhinoplasty, and eyelid surgery. The mean physician rating was 4.6, with 87% of reviews being 5-star and 5% being 1-star. Sentiment analysis revealed positive consumer sentiment in 5-star reviews and negative sentiment in 1-star reviews. CONCLUSIONS: These findings suggest that online reviews of doctors are polarized by extreme ratings. Within the surgical category, significant differences in ratings exist between treatments. Perceived problems with postprocedural care are most associated with negative reviews, whereas satisfaction with a physician’s answers to patient questions is most associated with positive reviews. Polarization of physician reviews may suggest selection bias in reviewer participation.