Satisfied? A Content Analysis of Online Surgeon Reviews

Background – Online review sites have become a modern version of the word-of-mouth recommendation, as prospective patients are increasingly consulting them before making decisions about their medical care. The impact of online reviews will only intensify in the coming years. Yet as of 2017, the literature evaluating online surgeon ratings and reviews remains sparse. Objectives – To: 1) identify common reasons for patient satisfaction and dissatisfaction with plastic surgeons; and 2) evaluate the usefulness and reliability of online reviews as a methodology for understanding the patient experience. Methods – Data was obtained from RealSelf and Yelp via a “web crawling” computer program based in R with the “XML” package. Data from Google Reviews was obtained manually. Our six metro areas of interest included New York, Los Angeles, Chicago, Houston, Philadelphia, and Miami. A positive review was defined as having 4 or 5 stars on Google and Yelp, or “Worth It” rating on RealSelf. Patients leaving a positive review were considered to be satisfied. A negative review was defined as having 1 or 2 stars on Google and Yelp, or “Not Worth It” rating on RealSelf. Patients leaving a negative review were considered to be dissatisfied. Content analysis was used to qualitatively evaluate each review. Reasons for satisfaction or dissatisfaction were then ranked from most common to least, and this was compared to reported satisfaction rates from the plastic surgery literature. Results – Word counts tended to be higher for negative reviews (1 or 2 stars) than for positive reviews (4 or 5 stars), suggesting patients tend to write more when they are dissatisfied. The importance of each rating website likewise varied according to the metropolitan area. For example, Miami had 2344 Google reviews for the top 10 plastic surgeons and 488 Yelp reviews for the top 20 plastic surgeons. On the contrary, Los Angeles had 3000 Yelp reviews for the top 20 plastic surgeons and 283 Google reviews for the top 10 plastic surgeons, highlighting the relative importance of Yelp over Google reviews for surgeons in the Los Angeles metropolitan area. “Good Aesthetic Outcome”, “Good Bedside Manner”, “Office Staff Friendly and/or Helpful”, “Has Expertise”, and “Listened to Patient” consistently ranked in the top five most commonly mentioned reasons for patient satisfaction in positive reviews for all websites sampled in this study, suggesting these may be key drivers of satisfaction for plastic surgery patients. “Reasonable Cost” was the least commonly mentioned reason for patient satisfaction in positive reviews. Conclusions – The reasons for patient satisfaction and dissatisfaction identified in our study analyzing online reviews demonstrate notable similarity to drivers of satisfaction and dissatisfaction as reported in the plastic surgery literature, suggesting online content analysis may represent a novel and reliable methodology for better understanding the patient’s perspective.