Department of Information Systems, Statistics, and Management Science, The University of Alabama, Tuscaloosa, AL, United States.
Department of Systems and Technology, Auburn University, Auburn, AL, United States.
J Med Internet Res. 2022 Apr 8;24(4):e31659. doi: 10.2196/31659.
Web-based reviews of physicians have become exceedingly popular among health care consumers since the early 2010s. A factor that can potentially influence these reviews is the gender of the physician, because the physician's gender has been found to influence patient-physician communication. Our study is among the first to conduct a rigorous longitudinal analysis to study the effects of the gender of physicians on their reviews, after accounting for several important clinical factors, including patient risk, physician specialty, and temporal factors, using time fixed effects. In addition, this study is among the first to study the possible gender bias in web-based reviews using statewide data from Alabama, a predominantly rural state with high Medicaid and Medicare use.
This study conducts a longitudinal empirical investigation of the relationship between physician gender and their web-based reviews using data across the state of Alabama, after accounting for patient risk and temporal effects.
We created a unique data set by combining data from web-based physician reviews from the popular physician review website, RateMDs, and clinical data from the Center for Medicare and Medicaid Services for the state of Alabama. We used longitudinal econometric specifications to conduct an econometric analysis, while controlling for several important clinical and review characteristics across four rating dimensions (helpfulness, knowledge, staff, and punctuality). The overall rating and these four rating dimensions from RateMDs were used as the dependent variables, and physician gender was the key explanatory variable in our panel regression models.
The panel used to conduct the main econometric analysis included 1093 physicians. After controlling for several clinical and review factors, the physician random effects specifications showed that male physicians receive better web-based ratings than female physicians. Coefficients and corresponding SEs and P values of the binary variable GenderFemale (1 for female physicians and 0 otherwise) with different rating variables as outcomes were as follows: OverallRating (coefficient -0.194, SE 0.060; P=.001), HelpfulnessRating (coefficient -0.221, SE 0.069; P=.001), KnowledgeRating (coefficient -0.230, SE 0.065; P<.001), StaffRating (coefficient -0.123, SE 0.062; P=.049), and PunctualityRating (coefficient -0.200, SE 0.067; P=.003). The negative coefficients indicate a bias toward male physicians versus female physicians for aforementioned rating variables.
This study found that female physicians receive lower web-based ratings than male physicians even after accounting for several clinical characteristics associated with the physicians and temporal effects. Although the magnitude of the coefficients of GenderFemale was relatively small, they were statistically significant. This study provides support to the findings on gender bias in the existing health care literature. We contribute to the existing literature by conducting a study using data across the state of Alabama and using a longitudinal econometric analysis, along with incorporating important clinical and review controls associated with the physicians.
自 21 世纪 10 年代初以来，基于网络的医生评价在医疗保健消费者中变得非常流行。一个潜在影响这些评价的因素是医生的性别，因为医生的性别已经被发现会影响医患沟通。我们的研究是首批使用时间固定效应进行严格纵向分析，以研究医生性别对其评价的影响的研究之一，同时考虑了几个重要的临床因素，包括患者风险、医生专业和时间因素。此外，这项研究是首批使用来自阿拉巴马州的全州数据研究基于网络的评价中可能存在的性别偏见的研究之一，阿拉巴马州是一个以农村为主的州，医疗补助和医疗保险的使用率较高。
本研究使用阿拉巴马州全州数据，在考虑患者风险和时间效应后，对医生性别与他们的网络评价之间的关系进行了纵向实证调查。
我们通过将来自流行医生评价网站 RateMDs 的医生在线评价数据与阿拉巴马州医疗保险和医疗补助服务中心的临床数据相结合，创建了一个独特的数据集。我们使用纵向计量经济学规范进行计量经济学分析，同时控制了四个评价维度（帮助性、知识、员工和准时性）的几个重要临床和评价特征。RateMDs 的整体评价和这四个评价维度被用作因变量，医生性别是面板回归模型中的关键解释变量。
用于进行主要计量经济学分析的面板包括 1093 名医生。在控制了几个临床和评价因素后，医生随机效应规范表明，男性医生获得的在线评价优于女性医生。不同评价变量的二元变量 GenderFemale（1 代表女性医生，0 代表男性医生）的系数和相应的 SE 和 P 值如下：整体评价（系数-0.194，SE 0.060；P=.001）、帮助性评价（系数-0.221，SE 0.069；P=.001）、知识评价（系数-0.230，SE 0.065；P<.001）、员工评价（系数-0.123，SE 0.062；P=.049）和准时性评价（系数-0.200，SE 0.067；P=.003）。负系数表明，在上述评价变量中，男性医生相对于女性医生存在偏见。
即使考虑了与医生相关的几个临床特征和时间效应，本研究发现女性医生获得的在线评价低于男性医生。虽然 GenderFemale 的系数幅度相对较小，但它们具有统计学意义。本研究为现有医疗保健文献中的性别偏见发现提供了支持。我们通过使用阿拉巴马州全州数据和进行纵向计量经济学分析，并结合与医生相关的重要临床和评价控制，为现有文献做出了贡献。
