Gender in Online Doctor Reviews

Dunivin Z, Zadunayski L, Baskota U, Siek K, Mankoff J. Gender, Soft Skills, and Patient Experience in Online Physician Reviews: A Large-Scale Text Analysis. Journal of Medical Internet Research. 2020;22(7):e14455.

This study examines 154,305 Google reviews from across the United States for all medical specialties. Many patients use online physician reviews but we need to understand effects of gender on review content. Reviewer gender was inferred from names.

Reviews were coded for overall patient experience (negative or positive) by collapsing a 5-star scale and for general categories (process, positive/negative soft skills). We estimated binary regression models to examine relationships between physician rating, patient experience themes, physician gender, and reviewer gender.

We found considerable bias against female physicians: Reviews of female physicians were considerably more negative than those of male physicians (OR 1.99; P<.001). Critiques of female physicians more often focused on soft skills such as amicability, disrespect and candor. Negative reviews typically have words such as “rude, arrogant, and condescending”

Reviews written by female patients were also more likely to mention disrespect (OR 1.27, P<.001), but female patients were less likely to report disrespect from female doctors than expected.

Finally, patient experiences with the bureaucratic process also impacted reviews. This includes issues like cost of care. Overall, lower patient satisfaction is correlated with high physician dominance (e.g., poor information sharing or using medical jargon)

Limitations of our work include the lack of definitive (or non-binary) information about gender; and the fact that we do not know about the actual outcomes of treatment for reviewers.

Even so, it seems critical that readers attend to the who the reviewers are when reading online reviews. Review sites may also want to provide information about gender differences, control for gender when presenting composite ratings for physicians, and helping users write less biased reviews. Reviewers should be aware of their own gender biases and assess reviews for this (http://slowe.github.io/genderbias/).

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