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The U.S. government has acknowledged the critical role that teachers play in the production of Science, Technology, Engineering, and Mathematics (STEM) professionals who will drive our nation’s economy. The No Child Left Behind Act of 2001 (NCLB) was passed to improve the quality of education nationwide, in part, by decreasing the number of out-of-field (OOF) teachers. However, the impact of NCLB and related efforts on the current state of OOF teaching in high school science and mathematics has yet to be examined. Our analysis of data from the National Teacher and Principal Survey (NTPS) indicates that from 2003–2016, the proportion of OOF teachers in chemistry and physics has increased, and there has been an increase in the number of students assigned to OOF teachers across subjects. We discuss the societal impact of our results and the critical role that policymakers, school administrators, and academic institutions, particularly university faculty, can play in its solution.

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Objective The influence of online physician ratings is growing, yet their interpretation remains difficult. Our aim was to analyze the online content of urogynecologists on 1 website to transform these ratings into practical tools for care improvement. Methods This cross-sectional analysis studied the ratings and reviews of every board-certified urogynecologist listed on Healthgrades.com. The ratio of 5:1 ratings was compared between various physician characteristics and practice qualities. Four investigators classified narrative reviews into one or more of the following themes: about the (1) physician, (2) clinical outcomes, (3) and/or staff. The content of the narrative reviews was analyzed, and word clouds were created to understand the primary motivators behind ratings. Results In February 2018, the Healthgrades pages for 689 urogynecologists were evaluated, and 523 physicians were included in the study. Higher 5:1 ratios were found among men versus women (4.0 vs 3.0; P < 0.01), and OB-GYN–trained versus urology-trained (4.0 vs 2.2; P < 0.01) physicians. A benchmarking rubric was developed to illustrate the 5:1 ratio distribution for all physicians stratified by number of ratings. A total of 3300 narrative reviews were assigned themes with strong inter- and intrarater reliability (Table 3). Physician qualities most influenced extreme scores (1 or 5 stars), whereas average reviews were more influenced by staff. Commonly discussed physician qualities included professionalism, time with patient, and counseling. Conclusions Using the 5:1 rating ratio and simplified review themes as tools, physicians can understand what their ratings signify both as an indicator of their online reputation compared with their peers and as a means for improving the patient experience.