Female cardiologists much more likely to receive negative reviews
Female cardiologists are much more likely to receive a negative review from patients than their male colleagues, according to new data published in JACC: Advances.[1]
“The patient experience is at the core of patient-centered medical care,” wrote corresponding author Jennifer Woo, MD, a cardiologist and clinical assistant professor with Stanford Medicine, and colleagues. “Online physician review websites are increasingly being used to measure patient experience and publicly evaluate individual physicians.”
Woo et al. noted that data on online cardiologist reviews are limited. Hoping to shed some light on the topic, the group examined more than 100,000 online reviews for more than 9,400 unique cardiologists. Reviews were left on the website Healthgrades from 1998 to 2023. While 89% of cardiologists were male, 11% were female. The mean cardiologist age was 57.7 years old.
Each review included in the analysis included a comment and a rating between one and five stars, with five being the highest possible score. The researchers turned to artificial intelligence (AI) to see what they could learn from this massive dataset, using a large language model (LLM) to deliver a “more nuanced understanding” of each review.
Overall, 84.6% of cardiologists received a five-star rating, 10.5% received a single star and the remaining cardiologists received two to four stars.
Positive reviews were linked to high ratings in staff friendliness, provider time, provider answers and provider trust. Long wait times stood out as one easy way to be given a poor rating—cardiologists associated with making patients wait too long were more than 70% less likely to receive a positive review.
Common two-word phrases included in positive reviews were “highly recommended,” “takes time,” “answers questions” and “saved life.” Common two-word phrases in negative reviews, on the other hand, were “office staff,” “stress test,” “bedside manner” and “blood pressure.”
Perhaps the biggest single takeaway from the team’s work was that female cardiologists received lower ratings than male cardiologists by a significant margin. Even when controlling for all subratings and age, Woo and colleagues found that women were 34.5% less likely to be given a positive review than men. They emphasized that women are not associated with subpar patient care—in fact, female cardiologists are typically linked to better bedside manner and spending more time with patients.
“We confirm that there is a negative bias against female cardiologists, however, it is not clear what drives this bias,” the group wrote. “The reason for the lack of differences in review sentiment between female and male cardiologists, despite a difference in rating, remains unclear. We suspect that the frequency of two-word phrases in reviews may not have sufficiently captured the theme of the review and further research could use LLMs to analyze major themes across multiple written reviews. Moreover, future longitudinal studies examining changes over time would be valuable in understanding trends of ratings and sentiments.”
Cardiologists 55 years old and older were also less likely to receive positive reviews than their younger counterparts. The researchers wondered if this could be due to older cardiologists being associated with longer wait times, but the cause for this difference was ultimately unclear.
“More studies are needed to determine if these differences in ratings by age are reproducible on other physician rating website platforms and to better understand why younger cardiologists are rated higher than older cardiologists,” the authors wrote.
Woo et al. also emphasized that new policies may be needed that better address the needs of female and older cardiologists.
Click here to read the full study in JACC: Advances, an American College of Cardiology journal.
Michael has more than 18 years of experience as a professional writer and editor. He has written at length about cardiology, radiology, artificial intelligence and other key healthcare topics.