Online Reviews of Ophthalmology Groups: An Infodemiology Study of Patient Ratings (Preprint)
Authors: Mark Erica , Thomas Claire , Shepard Caroline 
Published: October 2022

UNSTRUCTURED

Many Americans reference online reviews when selecting a physician [1,2]. In a 2014 report, 59% of individuals cited online patient ratings as an important factor in choosing a physician [1]. The widespread use and influence of these ratings raises questions about their potential impacts on healthcare delivery.
Online reviews may have consequences for professional reputation and physician selection. There is value in discerning the factors that drive both positive and negative ratings, such that the former can be encouraged, and the latter minimized. Concerns have also been raised about how the setting of healthcare delivery (e.g., academic vs. private) and other systemic forces at play (e.g., gender and racial biases) could affect physicians’ online ratings [3].
Studies of online physician ratings have yielded clinically-relevant insights across a variety of medical specialties [3-6]. In ophthalmology, though, the factors driving online patient ratings remain largely unclear. In the present study, we evaluate whether certain ophthalmologist- and practice-related factors influence patient satisfaction, as reported in online ratings.
Methods
We analyzed Yelp reviews of ophthalmology practices (from 2013−2020) located in New York City, New York (n=150). Patient reviews were coded for overall rating, as either “low” (1- or 2-star) or “high” (4- or 5-star). Then, binary logistic regression was used to determine whether certain physician and practice-related factors increased the likelihood of receiving low versus high ratings.
Results
When patients knew the name of their treating ophthalmologist, online ratings were more likely to be high than low (OR=5.57; P=.01). Ophthalmology practices were more likely to respond to reviews after receiving low ratings (OR=0.238; P=.04). Interestingly, ratings were not associated with physician race, physician gender, practice type (academic vs. private), or the number of practice physicians.
Discussion
Patients were more likely to post high ratings when they knew the name of their treating ophthalmologist. A plausible rationale may be that patients are more likely to remember an ophthalmologist’s name when a warm introduction is made and a personal connection is felt. This finding is consistent with similar studies in other specialties that found ratings were influenced by physicians’ bedside manner and communication style [4-6].
Unlike previous studies, online ratings of ophthalmologists did not show associations with practice type (academic vs. private), physician race, or physician gender [3]. These cross-specialty differences raise interesting questions about how systemic influences may manifest differently across various care settings. Though, it’s also important to acknowledge this study’s narrow sampling scope, as findings may vary for practices in different communities and geographic regions.
Ophthalmology practices that received lower ratings were more likely to respond to reviews. These findings suggest that practices appreciate the influence of online ratings, and may be concerned by how low ratings could hurt practice reputation or dissuade future patients. To mitigate potential harm, ophthalmologists may feel incentive to provide context or a thoughtful response to negative online reviews.
We relay this exploratory data in the spirit of cultivating interest and generating hypotheses. Given the increasing influence of online patient reviews, further study is encouraged to clarify the driving factors behind high ratings, and to develop strategies to respond effectively to low ratings.