Online reviews reveal double standard for female physicians

Biased online reviews © Anela Ramba/peopleimages.com - stock.adobe.com

A study published last week in JAMA Network Open suggests that female physicians face harsher criticism in online patient reviews than their male counterparts — particularly regarding their interpersonal skills and technical competence.

The findings, based on an analysis of 345,053 written reviews and ratings of 167,150 physicians from Healthgrades.com, suggest potential gender biases in patient perceptions, which may shape physician reputations and career trajectories.

Researchers looked at reviews spanning from October 2015 to May 2020, using a natural language processing algorithm to classify comments related to physicians’ interpersonal manner and technical competence. The study found that female primary care physicians (PCPs) and surgeons were more likely than males to receive comments — both positive and negative — about their interpersonal manner.

However, when female physicians received negative feedback, they were disproportionately penalized in overall star ratings.

“Female PCPs were especially more likely to receive patient criticism of their interpersonal manner, and when receiving this criticism, they were disproportionately penalized in star ratings compared with male PCPs,” the authors wrote.

Weighing the possibility that female PCPs might actually provide objectively worse patient-centered care than males, the study referenced a 2014 study, published in Patient Education and Counseling (PEC), which found female physicians to be more patient-centered than males. This prior research suggests that the disparity in online ratings and reviews is likely due to bias, rather than actual differences in the quality of care.

The study also found that female physicians had higher odds than their male counterparts of receiving negative comments about their technical competence. Among those who received such critiques, female PCPs and surgeons were less likely to receive high star ratings than their male peers.

Even when patients left positive comments about their technical abilities, female PCPs were less likely than males to see those comments reflected in higher star ratings.

The implications of these findings extend beyond online reputation management, as patient reviews have a growing influence on physician selection and opportunities for career advancement. The study’s authors suggest that increased awareness of potential biases, along with structured interventions in patient feedback systems, may help mitigate gender disparities in physician evaluations.

As 84% of U.S. patients continue to consider online reviews prior to choosing their physicians, health care institutions and practices should consider how gender biases may shape public perception, and explore strategies to ensure fair assessments for all practitioners.

Potential solutions identified in the study include efforts to increase awareness of gender biases among reviewers and prospective patients, retooling survey measures to ensure ‘gender-balanced perceptions,’ and featuring objective or expert-derived measures of technical competence alongside patient reviews. 

Researchers call for future studies to assess the mechanisms behind these findings and to examine how patients’ perceptions may differ depending on other variables — including race and ethnicity, urbanicity and intersectional identities.