New Happy Patient Index Ranks Best & Worst U.S. Cities by Physician Reviews

DENVER (June 2, 2014) – Patients in San Francisco and Oakland appear to be happiest with their doctors, while the least satisfied American healthcare consumers live in other California cities as well as in New York State locales, according to an in-depth evaluation of the ever-contentious online reviews that many physicians denounce.

In a nationwide study, Denver-based Vanguard Communications – a healthcare marketing, public relations and communications technology firm – deployed special software to scour Internet reviews of 46,300 healthcare providers on Google+ and websites. Vanguard’s software collected ratings of individual doctors, group medical practices, clinics and hospitals in the 100 largest U.S. cities. Vanguard then ranked each city according to its average patient rating on the five-star scale used by both Google+ and

Vanguard tabulated the results in what the firm is calling the Happy Patient Index (HPI), providing a comparative snapshot of the state of satisfaction with American healthcare.

Cities in New York and California account for eight of the 10 unhappiest municipalities in the HPI, while cities with the happiest patients are spread coast to coast (and beyond) in nine different states in virtually every region, including Hawaii.
Vanguard also discovered that the majority of online reviewers gush over their healthcare providers: 56.8 percent give their physicians four stars or better; only one in eight doctors (12.1 percent) gets an average of less than two stars.

“From these findings, I’d say that doctors get much better reviews than hotels, restaurants and retail businesses,” said Vanguard CEO Ron Harman King. “Another discovery is that you can find happy patients everywhere, not just in sunny, warm places but also in relatively cloudy and damp locations such as Cleveland and Seattle.”

The happiest ten cities in the HPI:

(1) San Francisco / Oakland, Calif.; (2) Honolulu, Hawaii; (3) Indianapolis, Ind.; (4) Seattle, Wash.; (5) St. Louis, Mo.; (6) Cleveland, Ohio; (7) San Jose, Calif.; (8) Austin, Texas; (9) New Orleans, La.; (10) Birmingham, Ala.

The unhappiest ten cities in the HPI (starting with the unhappiest): (1) Bakersfield, Calif.; (2) Modesto, Calif.; (3) North Hempstead, N.Y.; (4) Sacramento, Calif.; (5) Buffalo, N.Y.; (6) Riverside, Calif.; (7) Orlando, Fla.; (8) San Bernardino, Calif.; (9) Washington, D.C.; (10) Huntington, N.Y.
Vanguard’s evaluators looked for correlations between rankings and each city’s population size and average income, age and educational attainment, as well as political leanings (blue cities versus red) – and even percentage of residents with health insurance – but found no such connections.
In concert with the saying that money doesn’t buy happiness, wealth does not appear to affect patient satisfaction.

Three of America’s wealthiest cities rank in the 20 unhappiest with their doctors: Arlington, Va. (median household income of $102,459, according to the U.S. Census), Huntington, N.Y. ($105,426), and North Hempstead, N.Y. ($104,378). At the same time, three of the top-10 happiest cities have mean household incomes below the national mean of $51,017: Indianapolis ($42,144), St. Louis ($34,384) and Cleveland ($26,556).

Online doctor reviews have fueled growing controversy over their accuracy and fairness, particularly among the medical profession, with some doctors suing their patients over comments on the Internet. Nonetheless, a recent study published in the Journal of the American Medical Association reports that among patients who used physician-review websites, 35 percent have selected healers based on good reviews, while 37 percent avoided doctors based on bad reviews.

For more information including rankings of all 100 cities and details on the study methodology, please visit



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