14 Feb UMichigan Study Reveals Gender Differences in Online Physician Reviews

MedicalResearch.com Interview with:

Dr. Madanay

Farrah Madanay, PhD
Postdoctoral Research Fellow
Center for Bioethics and Social Sciences in Medicine
Michigan Medicine
University of Michigan

MedicalResearch.com: What is the background for this study?

Response: Patients are increasingly using online forums to evaluate their physicians, with not only star ratings but also written narrative reviews. These reviews tend to fall into two dimensions: interpersonal manner, which includes comments about the physician’s attitude, behavior, and communication; and technical competence, which includes comments about the physician’s knowledge, skill, and outcomes. These two dimensions are important for patient-centered care and align with research from social psychology.

Whereas prior studies have revealed gender differences in workplace assessments and overall star ratings of physicians, little is known about physician gender differences in patients’ online written reviews. We were curious whether physician gender differences were prevalent in patients’ written reviews and consistent across physician specialties, from generalists, like primary care physicians, to proceduralists, like surgeons.

We collected physician profile, rating, and review data from one of the largest commercial physician rating and review websites. We focused on physicians from three primary care specialties (family medicine, internal medicine, and pediatrics), and three surgical specialties (general surgery; orthopedic surgery; and cosmetic, plastic, and reconstructive surgery). Our final sample included 345,053 online reviews received by 167,150 U.S. physicians between 2015 and 2020.

We used hand-coded reviews to train an advanced natural language processing algorithm to classify all reviews for the presence and valence of patients’ comments of physicians’ interpersonal manner and technical competence. We then conducted multilevel logistic regressions to analyze differences by female or male physician gender in interpersonal manner and technical competence comments and whether those comments were associated with review star ratings.

MedicalResearch.com: What are the main findings?

Response:  Female physicians were more likely than males to receive any patient comments and negative comments about their interpersonal manner. Female primary care physicians were especially more likely to receive negative patient comments about their interpersonal manner, and when receiving these negative comments, they were disproportionately penalized in star ratings compared to male primary care physicians.

Female physicians were also more likely than males to receive negative patient comments about their technical competence. When receiving negative comments about their technical competence, both female primary care physicians and female surgeons were disproportionately penalized in star ratings compared to their male counterparts. Female primary care physicians were also less likely rewarded in star ratings when receiving positive patient comments about their technical competence compared with male primary care physicians.

MedicalResearch.com: What should readers take away from your report?

Response: This study showed differences in physician gender exist in patients’ online written reviews, vary by practicing specialty, and disproportionately penalize female physicians in star ratings.

Practically, these gender differences may have implications for patient acquisition and quality improvement, with potentially greater consequences for traditional patient experience surveys linked to incentives, reimbursement, and promotion.

Additionally, we demonstrated that advanced natural language processing methods can enable accurate classification of unstructured textual data. Potential extensions include analyses of clinical notes, patient portal messages, and social media posts.

MedicalResearch.com: What recommendations do you have for future research as a results of this study?

Response: Future research is needed to test interventions to minimize gender bias in patients’ evaluations of their physicians’ interpersonal manner and technical competence. Interventions should focus on both patient experience survey questions and narrative patient feedback. Future research may also examine how prospective patients are using these patient reviews to make decisions about their care.

Citation:

Madanay F, Bundorf MK, Ubel PA. Physician Gender and Patient Perceptions of Interpersonal and Technical Skills in Online Reviews. JAMA Netw Open. 2025;8(2):e2460018. doi:10.1001/jamanetworkopen.2024.60018
https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2830232

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Last Updated on February 14, 2025 by Marie Benz MD FAAD