Association between patient value systems and physician and practice attributes available online

IMPORTANCE The relative value of facial plastic surgeon personal and practice attributes is relevant to the broader health care system because of increasing out-of-pocket expenses to patients. OBJECTIVE To determine the relative value of specific facial plastic surgeon personal and practice attributes available online from the perspective of patients. DESIGN, SETTING, AND PARTICIPANTS This study consisted of an electronic survey sent to patients by email using choice-based conjoint analysis; surveys were sent between December 2015 and March 2016. Participants had agreed to join email registries to be sent email surveys and promotions at 3 private facial plastic and reconstructive surgery practices. The following surgeon personal and practice attributes and levels were compared: (1) outcome transparency (above average, average, not available); (2) surgical training affiliations (US News andWorld Reports rankings); (3) online rating site scores (2 [poor], 3, or 4 [excellent] stars); and (4) price ($1×, $2×, and $3× [× = $1500; average cost was set at $2×]). MAIN OUTCOMES AND MEASURES The relative importance of outcome transparency, surgical training affiliations, online rating scores, and price to prospective patients. RESULTS Overall, 291 patients participated for a completion rate of 68%. Outcome transparency was the most valued attribute (attribute utility range = 141; attribute importance = 35.2%). Price was the least valued attribute (attribute utility range = 58.59; attribute importance = 15.1%). Assuming top-tier affiliations and 4-star ratings, share of market (SOM) was 75.5%for surgeons with above-average outcome transparency priced at $3× compared with those surgeons with no outcomes available priced at $1×. Holding price constant at $2×, surgeons with middle-tier affiliations and 2-star online ratings but above average outcomes achieved 48.4%SOM when compared with those surgeons with top-tier affiliations and 4-star online ratings without available outcomes. CONCLUSIONS AND RELEVANCE Facial plastic surgery patients most value surgeons who publish outcomes. Moreover, they are willing to discount poor rating scores and lower-ranked institutional affiliations when outcome transparency is high. This study demonstrates that outcome transparency is crucial in facial plastic surgery markets.