# Beyond the Procedure: Non-Clinical Complaints and Gender Disparity Dominate One-Star Yelp Reviews of Pain Physicians

## TL;DR

This study finds that most negative Yelp reviews for pain physicians are due to non-clinical issues and that female providers receive more one-star reviews than male providers.

## Contribution

The study identifies non-clinical complaints and gender disparities as key drivers of extreme patient dissatisfaction in pain medicine.

## Key findings

- Non-clinical issues accounted for 70% of one-star Yelp reviews for pain physicians.
- Female-only practices received significantly more one-star reviews compared to male-only and mixed-gender practices.
- Solo practices had a higher rate of one-star reviews than group practices.

## Abstract

Yelp.com allows patients to review their experiences. Few studies have focused on dissatisfaction in pain medicine. This study aims to characterize one-star Yelp reviews of anesthesiology-trained pain physicians to better understand the scope and nature of extreme patient dissatisfaction.

Non-clinical issues comprised the most complaints (n = 927; 70%), while clinical concerns comprised 391 (30%). Office staff communication topped non-clinical complaints (n = 200). Unsatisfactory results (n = 90) topped clinical concerns. Eastern cities like Philadelphia, PA (53%) had the most one-star reviews, whereas Western cities such as Los Angeles, CA (21%) had the lowest. Solo practices were associated with a higher rate of one-star reviews (33%) than group practices (28%). Gender-based analysis showed that female-only practices received significantly more one-star reviews (mean = 12.17) compared to male-only (mean = 2.90) and mixed-gender (mean = 7.00) practices. Poisson regression analysis indicated a higher relative risk of one-star reviews for female providers (RR = 1.00 [ref]), with reduced risk for male providers (RR = 0.58) and increased risk for mixed-gender practices (RR = 1.40; all p < 0.001).

Patient dissatisfaction is most frequently due to non-clinical experiences. Regional factors, practice type, and physician gender demonstrated significant associations with patterns of patient dissatisfaction. Eastern cities exhibited higher rates of negative reviews. Solo practitioners appeared more susceptible to critical feedback. Female providers seemed to have a disproportionate number of one-star ratings. These trends may reflect underlying systemic and implicit biases and demonstrate vulnerabilities within specific practice models.