Do health care providers use online patient ratings to improve the quality of care?

Background: Physician-rating websites have become a popular tool to create more transparency about the quality of health care providers. So far, it remains unknown whether online-based rating websites have the potential to contribute to a better standard of care. Objective: Our goal was to examine which health care providers use online rating websites and for what purposes, and whether health care providers use online patient ratings to improve patient care. Methods: We conducted an online-based cross-sectional study by surveying 2360 physicians and other health care providers (September 2015). In addition to descriptive statistics, we performed multilevel logistic regression models to ascertain the effects of providers' demographics as well as report card-related variables on the likelihood that providers implement measures to improve patient care. Results: Overall, more than half of the responding providers surveyed (54.66%, 1290/2360) used online ratings to derive measures to improve patient care (implemented measures: mean 3.06, SD 2.29). Ophthalmologists (68%, 40/59) and gynecologists (65.4%, 123/188) were most likely to implement any measures. The most widely implemented quality measures were related to communication with patients (28.77%, 679/2360), the appointment scheduling process (23.60%, 557/2360), and office workflow (21.23%, 501/2360). Scaled-survey results had a greater impact on deriving measures than narrative comments. Multilevel logistic regression models revealed medical specialty, the frequency of report card use, and the appraisal of the trustworthiness of scaled-survey ratings to be significantly associated predictors for implementing measures to improve patient care because of online ratings. Conclusions: Our results suggest that online ratings displayed on physician-rating websites have an impact on patient care. Despite the limitations of our study and unintended consequences of physician-rating websites, they still may have the potential to improve patient care.

The effects of attractiveness and underlying components on the motivational salience and the memorability of face photographs

Facial attractiveness is a particularly salient social cue that influences many important social outcomes. Using a standard key-press task to measure motivational salience of faces and an old/new memory task to measure memory for face photographs, this thesis investigated both within-woman and between-women variations in response to facial attractiveness. The results indicated that within-woman variables, such as fluctuations in hormone levels, influenced the motivational salience of facial attractiveness. However, the between-women variable, romantic relationship status, did not appear to modulate women’s responses to facial attractiveness. In addition to attractiveness, dominance also contributed to both the motivational salience and memorability of faces. This latter result demonstrates that, although attractiveness is an important factor for the motivational salience of faces, other factors might also cause faces to hold motivational salience. In Chapter 2, I investigated the possible effects of women’s salivary hormone levels (estradiol, progesterone, testosterone, and estradiol-to-progesterone ratio) on the motivational salience of facial attractiveness. Physically attractive faces generally hold greater motivational salience, replicating results from previous studies. Importantly, however, the effect of attractiveness on the motivational salience of faces was greater in test sessions where women had high testosterone levels. Additionally, the motivational salience of attractive female faces was greater in test sessions where women had high estradiol-to-progesterone ratios. While results from Chapter 2 suggested that the motivational salience of faces was generally positively correlated with their physical attractiveness, Chapter 3 explored whether physical characteristics other than attractiveness contributed to the motivational salience of faces. To address this issue, I first had the faces rated on multiple traits. Principal component analysis of third-party ratings of faces for these traits revealed two orthogonal components that were highly correlated with trustworthiness and dominance ratings respectively. Both components were positively and independently related to the motivational salience of faces. While Chapter 2 and 3 did not examine the between-woman differences in response to facial attractiveness, Chapter 4 examined whether women’s responses to facial attractiveness differed as a function of their romantic partnership status. As several researchers have proposed that partnership status influences women’s perception of attractiveness, in Chapter 4 I compared the effects of men’s attractiveness on partnered and unpartnered women’s performance on two response measures: memory for face photographs and the motivational salience of faces. Consistent with previous research, women’s memory was poorer for face photographs of more attractive men and more attractive men’s faces held greater motivational salience. However, in neither study were the effects of attractiveness modulated by women’s partnership status or partnered women’s reported commitment to or happiness with their romantic relationship. A key result from Chapter 4 was that more attractive faces were harder to remember. Building on this result, Chapter 5 investigated the different characteristics that contributed to the memorability of face photographs. While some work emphasizes relationships with typicality, familiarity, and memorability ratings, more recent work suggests that ratings of social traits, such as attractiveness, intelligence, and responsibility, predict the memorability of face photographs independently of typicality, familiarity, and memorability ratings. However, what components underlie these traits remains unknown, as well as whether these components relate to the actual memorability of face photographs. Principal component analysis of all these face ratings produced three orthogonal components that were highly correlated with trustworthiness, dominance, and memorability ratings, respectively. Importantly, each of these components also predicted the actual memorability of face photographs.