First Impressions: How Surgeon Gender and Race in Social Media Profile Pictures Affect Patient Perception in Plastic Surgery.

Background: Social media has emerged as an essential platform for plastic surgeons to advertise to potential new patients. Among the various factors influencing a patient's choice of physician, implicit bias plays a significant role. This study aims to investigate whether a surgeon's gender or race, as presented in their social media profile picture, affects the perception of their competence and the likelihood of attracting patients.

Methods: Two side-by-side sample Instagram posts were created. Each post displayed a before-and-after photograph of a common plastic surgery procedure and featured one of eight possible profile pictures generated using artificial intelligence, with variations only in gender and race. Surveys containing the posts, which only differed in the surgeon's profile pictures, were distributed to respondents to evaluate perceived surgeon competence, likelihood of recruiting patients, likelihood of making a referral, and willingness to visit the surgeon's profile.

Results: A total of 1777 respondents participated. The average scores were 3.74 (SD=0.98) for competence, 3.64 (SD=1.06) for patient recruitment likelihood, 3.72 (SD=1.00) for referral, and 3.68 (SD=1.05) for social media influence. Surgeon ethnicity or gender did not significantly affect scores, and no significant pairwise differences were found between respondent and surgeon ethnicities across all categories.

Conclusions: Our results showed no significant differences in patient recruitment, referral likelihood, perceived competence, or social media influence based on surgeon gender or race. These findings suggest that using controlled images, which standardize factors like clothing, name, and other superficial identifying features, may help reduce the influence of demographic biases.

Level of evidence iii: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .