Surgeons are 13x more likely to receive a 1-star review on Yelp

Have you ever had a Yelper give a “1 star” (Highly Dissatisfied) rating to your practice? If you’re like me, you might be able to accept that 1% of your cosmetic surgery patients won’t be highly satisfied.

But what if that Highly Dissatisfied number is 13%? Wouldn’t that defy belief? Yet, based on Yelp’s own statistics, 13% of its ratings are from Highly Dissatisfied reviewers. To make matters worse, MarketWatch confirmed in the fall of 2013 that up to 25% of Yelp’s reviews are fake.

ljcsc-yelp dist

Yelp ratings distribution in 2011 for La Jolla Cosmetic Surgery Centre

I founded RealPatientRatings® because as the leader of an established and respected cosmetic surgery practice in San Diego, CA, I was livid about the grossly inaccurate view of our practice as presented on Yelp.

Our overall rating equated to a C+ and I knew from our past survey responses that La Jolla Cosmetic Surgery Centre was not a C+ practice. Most astonishingly to me, 33% of our Yelp reviews were negative or neutral. It made no sense. I could not rely on such a flawed system to represent our practice.

100% verified ratings distribution on for La Jolla Cosmetic Surgery Centre, 2014

100% verified ratings distribution on for La Jolla Cosmetic Surgery Centre, 2014

After RealPatientRatings began soliciting feedback within a closed system, it turned out that our score from our real patients was a solid A with an overall rating of 94.6%. The negative and neutral scores were only 4%, which made a lot more sense.

As RealPatientRatings grew and the statistics for our fellow members reflected those of my own practice, I continued to watch in astonishment at the low ratings on sites that allow anyone to post.

Last month I discovered Yelp’s overall distribution of ratings across all of their reviews, which has since been taken down. This distribution matches the numbers that so inaccurately described our practice.

yelp-ratings-distribution-sept-2013 ratings

The distinction between verified patients and Yelpers is significant.

Among those Yelp reviewers are many non-patients, not just for my practice, but for every business listed on Yelp.

With almost 50,000 verified ratings having been generated by RPR, our data provides scientific and accurate insights about how cosmetic surgery patients rate their doctors – absent the trolls, fake reviews and murky algorithms used by sites with flawed review systems.

Surgeons are 13x more likely to receive a 1 Star review on Yelp.

These startling differences in results prove the impact of fake reviews on your reputation and on the likelihood of consumers to choose you as their provider.

According to RPR data, 95% of verified patients rate their satisfaction with their cosmetic plastic surgery experience as either satisfied or highly satisfied.


In reality, extreme dissatisfaction is rare

Only 5% of patients rate their experience among the neutral, dissatisfied and highly dissatisfied categories, of which only 1% is highly dissatisfied.

Contrast these numbers with the ratings distribution published on the Yelp website for all its listings. Remember, anyone (including your competitor or former employee) can represent themselves as your patient and write a negative review on Yelp. While Yelp is working actively to identify and remove such reviews, their own data shows how far they have to go.

Only 67% of Yelp reviews are from highly satisfied (41%) and satisfied Yelpers (26%).

The remaining 33% of Yelp’s ratings fall into the neutral, dissatisfied and highly dissatisfied categories. Looking only at the 1 star ratings, a whopping 13% are highly dissatisfied which is 13x greater than with RPR’s verified ratings.

Comparing Yelp and RealPatientRatings® Data.

MarketWatch’s 25% estimate of suspicious reviews is quite close to the mark. As you will see from the analysis below between and Yelp, there is a difference of 28% in favorable ratings between verified reviews and an open system like Yelp. Or in the reverse, a difference of 28% in unfavorable ratings when moving from an open system to a verified system of reviews.

  • Considering Positive Ratings Only (4’s & 5’s). There is an absolute decline of favorable ratings of 28% on Yelp vs. RPR. Or, a relative increase of 42% of positive responses with RPR’s verified reviews rather than Yelp’s system.
  • Considering Negative or Neutral Ratings Only (3’s, 2’s and 1’s). There is an absolute increase in negative ratings of 28% on Yelp vs. RPR. Or, 660% relative increase in unfavorable ratings on Yelp vs. RPR.

This data goes a long way to explain the frustration of most surgeons with Yelp and with other flawed reviewed sites that allow anyone to post a review. Indeed a recent ruling by the 9th Circuit affirmed Yelp’s right to manipulate its ratings for money.

Meanwhile, consumers are using these faulty ratings and reviews as if they present a true and accurate picture of practice quality. They are making important choices based on erroneous information about the level of patient satisfaction in our practices. To the extent you don’t acknowledge this consumer reality, and the ratings about your practice are not accurate, you can anticipate a decline in new patient flow.

The only rational answer to this situation is to have your own ratings and review strategy. If you want more prospective patients:

  • Profit from the increasing consumer demand for ratings and reviews
  • Publish 100% verified third-party ratings and reviews directly on your practice website
  • Ensure that an accurate and current assessment of your practice’s quality is available 24/7

Every day more consumers are using reviews to decide which doctor they will choose.

When RealPatientRatings began in 2011, Pew Research reported that 12% of adults had consulted online rankings or reviews of doctors or other providers.

Three years later, these numbers have reversed… now only 12% of consumers do NOT read online reviews, and 88% of consumers say they trust online reviews as much as personal recommendations.

Given this massive shift in consumer behavior, the effect of flawed and distortedly negative reviews sites is an even greater problem for physicians.

All this leads to RealPatientRatings. We’re so convinced that you’ll experience increased conversions that we offer a free trial. 

Marie Olesen
Founder, RealPatientRatings®