Impact of Patient Rating Propensities on the Online Rating of Orthopaedic Surgeons. A Retrospective Analysis of Google Reviews

Background Online reviews are increasingly influential in patient decision-making when selecting a surgeon. Although healthcare-specific factors are known to shape patient satisfaction, the potential role of non-healthcare-related predispositions in shaping online reviews remains underexplored. Questions/Purposes: (1) Do individuals who leave extreme ratings (1-star or 5-star) for surgeons on Google tend to show similar rating behaviors when reviewing other products and services? (2) What is the difference in average rating behavior between these two reviewer groups? Methods A retrospective observational study was conducted across five academic institutions, evaluating Google reviews of orthopaedic surgeons. The purposes were to assess if individuals who leave extreme ratings (1-star or 5-star) for surgeons on Google tend to show similar rating behaviors when reviewing other products and services, as well as determine what is the difference in average rating behavior between these two reviewer groups. Reviewers were categorized into two cohorts: those who rated surgeons 1 star and those who rated surgeons 5 stars. The primary outcome was the average Google rating provided to other services and products by these reviewers. Results A total of 1,629 reviewers of 160 orthopaedic surgeons were included, of whom 97.2% (1584) provided either a 1-star or 5-star rating. Individuals who left extreme ratings for surgeons exhibited consistent rating behaviors elsewhere, with 1-star surgeon reviewers giving a significantly lower proportion of 5-star reviews for other products and services compared to 5-star surgeon reviewers (59.7% vs. 81.9%, p < 0.001). The average rating given to other products and services was significantly lower among 1-star surgeon reviewers than 5-star surgeon reviewers (3.7 vs. 4.5, p < 0.001) Conclusion Our findings suggest that patients who rate surgeons poorly may also tend to rate other products and services more negatively, while those who rate surgeons highly may exhibit a similar positive bias. These results highlight the potential influence of individual rating predispositions on online reviews, independent of healthcare-specific factors. Further research is needed to better understand how these tendencies affect patient satisfaction and to develop strategies for more objective review interpretations.