The urgency trap: Why emergency services save lives but lose stars

Digital review platforms increasingly shape perceptions of service quality, yet their interfaces may reinforce cognitive biases. We report an AI-assisted qualitative study of 150,192 Google Maps reviews across approximately 500 healthcare and home-service locations. Combining LLM-assisted thematic synthesis with manual analysis of 1,283 reviews, we identify an urgency-quality paradox: emergency departments consistently receive lower ratings than minor injury clinics despite reviewers acknowledging superior outcomes. Mean ratings were 3.3 versus 4.0, respectively. In high-urgency contexts, evaluations focused on waiting time and responsiveness, while outcomes mattered more in lower-urgency settings. We discuss implications for reputation-system design and bias mitigation.