Bullet Points:

  • Online physician ratings are important to patients
  • Prior studies concluded that negative reviews are influenced more by surgeon-independent factors (SI) (office and staff) than surgeon-dependent factors (SD)
  • We hypothesized that further study of the relationship between SI vs. SD factors was warranted
  • We analyzed the correlation of SD and SI components of HealthGrades.com reviews for US hand surgeons (78 surgeons across 8 practices)
  • SD and SI factors were highly correlated for surgeons within the same practice
  • In contrast to prior studies, we conclude that surgeon-dependent factors account for 87% of online reviews

Background & Objective:

Healthgrades, a prominent online physician review site, currently has over 100 million users. The literature to date suggests that negative reviews are predominantly influenced by surgeon-independent factors (i.e. admin staff, office environment) and positive reviews more than by surgeon-dependent factors.

In many cases, office-environment ratings can be variable even among surgeons practicing in the same office setting. With this data, it is possible to determine which factors are most closely correlated to overall rating scores.

The purpose of this study was to determine  if surgeon dependent factors had a larger impact on online reviews than surgeon independent factors utilizing correlation analysis.

Materials & Methods:

Study design included evaluation of SD and SI components of HealthGrades.com reviews for US hand surgeons (78 surgeons across 8 practices).

SD factors were based on the Healthgrades overall surgeon rating comprised of trustworthiness, time spent with patient, ability to answer questions, and explanation of conditions.

SI factors included the average Healthgrades rating of office staff, office environment, and wait time experience.

Correlations were analyzed between SD and SI factors within the same practice using the Pearson coefficient.

Mean correlation among all practices and the overall Pearson coefficient and significance were also calculated.

Summary: There were moderate to high correlations for all practices when comparing average SD ratings and average SI ratings within the same practice, range from 0.49-0.98.

Average office scores were narrowly distributed (Range: 4.0-4.7) among all practices allowing for a combined correlation value between SI and SD factors to be calculated. Correlation  was 0.87 with a level of significance <0.001.


Objectively, surgeon-independent factors are consistent within a practice.  However, their ratings appear to correlate very closely with surgeon-dependent qualities (87% correlation). These findings imply that surgeon-dependent factors alone account for 87% of online surgeon reviews.