It’s 2018, which means that before you do just about anything – pick a restaurant, buy new mascara, etc. – you’re probably reading online reviews. The bigger the decision, the more homework you’re likely to do.
But in the case of choosing a plastic surgeon, reading online reviews might actually be misleading, according to a new study.
Researchers at Northwestern University looked at more than 1,000 patient reviews of plastic surgeons on RealSelf, Yelp, and Google. “Online reviews have become the new word of mouth,” John Kim, a professor of plastic surgery at Northwestern University’s Feinberg School of Medicine and the study’s author, tells Allure. But instead of being helpful, that can actually be problematic, he says.
The study found three concerning things about online reviews for plastic surgeons. First off, researchers found that online reviews tend to be pretty extreme – either overwhelmingly positive or negative, which is perhaps not surprising if you’ve ever scrolled through Yelp. But that may lead to an unbalanced picture since “extremely happy or unhappy patients are more likely to take the trouble to write a review,” Darren Smith, a board-certified plastic surgeon in New York City, who was not involved with the study tells Allure. Of the reviews examined, there were significantly more one- and five-star reviews than more moderate evaluations.
A large number of patients who write negative reviews have never even had surgery with the doctor they are reviewing.
Beyond that, there are other concerns lurking in online reviews. “A large number of patients who write negative reviews have never even had surgery with the doctor they are reviewing,” Kim explains. Smith adds that there have also been some murky rumors that certain review sites may “suppress or influence physician aggregate ratings based on physician payments to the review site.” In other words, it’s important to take them with a grain of salt.
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Secondly, Kim and his colleagues found that customer service – how friendly the office receptionist is, how luxe the in-office experience feels, how long patients spend in the waiting room – plays a disproportionate role in how surgeons are rated online. In negative reviews, “patients almost always site a negative experience with staff in addition to their reservations about the physician,” Haideh Hirmand, a board-certified plastic surgeon in New York City not involved with the study, tells Allure. “They remember a generally negative experience, no matter the source of that feeling.”
Traditional measures of physician experience and skill can be overshadowed and perhaps distorted by online reviews.
This can be concerning when it comes to evaluating actual skill, Kim says. “Traditional measures of physician experience and skill can be overshadowed and perhaps distorted by online reviews,” he explains. “How the office staff handles patients can matter as much as the outcome of the surgery and the surgeon’s skill.” Obviously, in-office experience is important (more on that later), but it shouldn’t outweigh the actual skill of the surgeon.
That leads to the last concern raised by the study: Social media skill may be trumping surgical skill when it comes to online ratings for doctors. “It is plausible that a surgeon who has many years of experience and is skilled but doesn’t have a strong online review presence could easily be overlooked in favor of a less experienced, less skilled surgeon who has many more reviews,” says Kim. “In other words, online reviews may be acting as a surrogate for experience and skill.” There’s also the concern that less skilled surgeons with great customer service could be getting more positive reviews despite having subpar results, he adds.
Where customer service counts
There are important reasons why customer service plays so heavily into online reviews. When you have a choice between surgeons, “the choice is often due to who you feel most comfortable with and who you believe will support you through the procedure,” Melissa Doft, a board-certified plastic surgeon in New York City, who was also not involved with the story, tells Allure. In her practice, she says she strives to make the self-care of plastic surgery as restorative and easy as possible. “Plastic surgery is something that you do for yourself,” she says. “We want to make it as enjoyable as surgery possibly can be.”
That added focus on customer service might not just be fluff. “There is longstanding data that positive environments can actually improve health and contribute to healing,” Smith explains. “I also think a ‘high-touch’ open door practice enhances safety,” he says. The idea is that increased access to your surgeon – say, ability to him or her after hours with a concern – can help head off any complications.
What to know before choosing a plastic surgeon
Rather than relying solely on online reviews when searching for plastic surgeons, use them with caution. “I would read each one carefully and only use the doctor’s online reputation as one piece of the decision,” advises Doft. Other important factors should be recommendations from trusted friends who’ve had similar procedures, and recommendations from one of your existing doctors. “Your physician should have your health and wellness at top of mind and will most likely send you to someone they personally feel is competent and experienced,” Hirmand says.
Trust your gut feeling when you meet the surgeon and never feel pushed into booking a surgery.
It’s also important to make sure any plastic surgeon you consider is board-certified. “Board certification by the American Board of Plastic Surgery is a clear indication that a surgeon has completed rigorous training and is qualified to be performing plastic surgery procedures safely and efficaciously,” says Smith. Beware of doctors billed as “cosmetic surgeons,” adds Doft, as they might not be board certified. “Look at where surgeons have hospital affiliations,” she says.
Finally, meet a few surgeons in person before making a final choice. In addition to viewing photos of their work to make sure you have the same aesthetic goals, “trust your gut feeling when you meet the surgeon and never feel pushed into booking a surgery,” says Doft.
In short, online reviews can be helpful but they should never keep you from doing your homework on a surgeon’s actual credentials and surgical outcomes.