Taking Charge of Your Online Presence

One cannot underestimate the power of online reviews. How many of us would book a reservation at a new hotel or restaurant without consulting websites such as TripAdvisor or Open Table and reading what other people say about the places we are considering?

The same is true of our healthcare experiences. Studies have shown that a significant number of patients who are looking for a new provider want to know what current or former patients have to say. The growing popularity of online reviews is having a marked effect on how physicians practice.

Given the importance of your online presence, it helps to know where you stand. Google yourself. Most likely, you will find some positive and some negative reviews. Most of the rating sites provide basic data, such as where you went to medical school, years in practice, and the hospitals where you work. That is all the information you will find on some sites. There may be a couple of reviews from patients, but many sites will have no reviews at all.

If Google searches offer so little information, why waste your time? Here’s why it’s important and how you can take charge:

1. Establish a Positive Presence.

Research data show that consumers’ use of the Internet to find and comment on their experiences with healthcare is growing. If you do not have many ratings now, consider yourself lucky that you’re able to get in on the ground floor in establishing a positive online presence and cultivating positive reviews from your patients. Even your current patients may be watching!

Next year or the year after, when potential patients do a search and find several physicians’ profiles that meet their criteria for specialty or geography, you don’t want yours to be the profile with no information about your practice. A straightforward and positive online presence could boost your business now and in the future.

2. Correct Errors and Out-of-Date Information.

Review sites pre-populate their listings with data that are readily available, such as your practice name and address. However, the information they have is not always correct. Maybe one physician left your practice and joined another. Maybe your office has moved. Sometimes the information is completely wrong and there’s no explanation.

The best way to combat incorrect information is to “claim” your business listing. Most rating sites allow physicians to manage their basic data. Once you are verified as the legitimate owner of the business, you will have complete control over the information the site shows about you and your practice.

Do not neglect this step, as incorrect information can lead potential patients to the wrong address or directly to a competing practice. If you have moved to a new practice but the group you were previously with still exists, potential patients who call your old phone number will probably be offered an appointment with a doctor in that group. Most rating sites allow physicians to manage their basic data.

3. Read the Reviews.

Knowledge is power. No one wants their weaknesses broadcast to the whole world. Understandably, many healthcare professionals are nervous about the transparency brought about by social media, especially the trend toward online reviewing by patients. Feedback can be healthy, however, allowing you to discover ways to improve patients’ experiences with all aspects of your practice. Read the reviews and take them to heart.

4. Claim Your Identity.

One fact of life in our increasingly small and interactive world is that there are no names that are truly unique to one person. No matter how unusual you think your name is, chances are there is at least one other person somewhere in the world with the same name and with an Internet presence who is also a healthcare professional!

Internist Vineet Arora, MD, associate program director of the University of Chicago’s internal medicine residency program, tells what happened the first time she Googled herself.(1)

My online reputation was not something I had ever thought of until I had a bad one. When someone would Google my name, he or she would find the top hits referred to my exact namesake, Vineet Arora, an ophthalmologist in Ontario, Canada. This would not be so terrible, except that most of the links were accompanied by a headline like “Ophthalmologist accused of blinding patients.”

Needless to say, that really concerned me.

Would people think I was that guy? My name and even professional identity was associated with this other person. What’s worse is that my own faculty profile at the University of Chicago was not coming up high in the search. So at that moment, I decided to generate my own online content.

The first thing I did was set up a LinkedIn account as a landing page for myself that included a list of my positions. I will confess that I was afraid of being too “out there” at first, so I kept my LinkedIn page pretty barebones.

I link all my social media accounts to my LinkedIn page. I also created a Google profile and a very cool page on About.me to aggregate Web content related to my work. Controlling my online reputation allows me to control what people say about me, too. For example, when I give talks, I simply send my Google profile bio, as opposed to having someone reinvent the wheel from my CV.

I share my story with trainees so that they not only become familiar with their online reputation, but also take control of it. Even if they are not ready to dive fully into social media, setting up a LinkedIn page is an easy first step to building an online reputation.

Because I see patients only when they are hospitalized in an urban academic center that cares for an underserved, diverse population, my patients don’t likely know who I am until they meet me. But these days, the minute you hear about someone you don’t know, what do you do? You Google them. So I would not be surprised if that is what some of my patients do, and certainly more will do so in the future.

In this day and age, because your online reputation is often your first impression, it better be a good one.

Fear Not Online Ratings

Often, the topic of online ratings causes a sense of anxiety among physicians, as most have not been trained to deal with being reviewed online.

Many physicians say their greatest fear is Googling their name and seeing a negative review from one of these sites. What if, when you Googled yourself, you found comments like these, taken from real reviews at a physician rating site:

“Going to this dermatologist was a waste of time and money.”

“What a mistake. This man has the bedside manner of someone from the Amazon.”

It’s obviously not how you want patients to find you on the Web.

Despite the damage bad reviews can do to your online reputation, there is tremendous value in social media, and the time it takes to develop a strong online reputation is time well-spent. If you want to determine the impact of social media on your practice, simply ask new patients how they found you. A growing percentage are there because of information they found out about you online.

Also, consider this: Patients who’ve explored your practice online may also be more comfortable with you because they may feel as though they already know you. They may be more willing to share their concerns because they’ve read an article or an interview about you. In addition, because they have made a conscious decision to come to you (perhaps even selected you from among several choices), they may be more receptive to your instructions. Not only might this enhanced comfort level make the relationship between you and your patient stronger, but also it could minimize the chance that the patient will go elsewhere after the initial visit.

Monitor? Yes. Respond? Maybe, Maybe Not

Once you have an online presence, maintain your online reputation by monitoring online reviews as they appear. This should be an important part of your practice management agenda. Set up a Google alert for your practice so that any time a review is posted, you should get a notice about it. When you set up the alert, be sure to include providers’ names as well as the name of the practice so you are alerted whenever a review is posted about not only the practice, but also about individual providers.

Monitoring your profiles for reviews is always a good idea; responding to the reviews is another matter altogether. Medical professionals have different standards from other types of businesses that are reviewed online and some rules for reputation management don’t apply to you!

For example, Yelp encourages businesses to “create a Yelp deal” by offering discounts to customers who find businesses on their site. They also advise business owners to message customers and join the conversation. None of these techniques is appropriate for the medical practice.

However, physicians have several options for responding to patient reviews that are consistent with professional standards.

How to Respond to Negative Reviews

The good news is that studies have shown that most reviews of physicians are positive, but a negative review is inevitable. Online reputation companies often try to bury bad reviews by creating more positive information to improve the search rankings of a business.

Some of their strategies include publishing numerous press releases with positive news about the business or individual, and creating multiple websites about various products and services of a business as a way to divert attention away from the negative reviews, and give it more positive visibility in search results. Most medical practices do not lend themselves to these types of solutions.

Doctors actually have numerous options for responding to patient reviews. Eric Goldman, professor of law at Santa Clara University School of Law has written extensively on legal issues relating to online rating sites and offers these suggestions(2):

• Respond generally. Because most negative reviews relate to non-clinical aspects of the practice such as parking, wait times, out-of-date magazines, or staff attitude, doctors can respond to those issues directly within the review site without violating privacy laws. Explain these aspects of your practice without confirming or denying that the reviewer was your patient. Explain how you run your practice in general terms, but refrain from publicly talking about the specifics of any one patient’s experience.

• Address individuals offline. Responding to negative reviews that criticize bedside manner or question medical judgment should never be done in a public forum. Some sites, like Yelp, allow providers to privately respond to patient reviews. You may take the opportunity to do so. But it’s better to take this conversation offline. An invitation to call the office to further discuss the concern is appropriate.

• Ask for permission to reply. Finally, you can ask patients for their permission to publicly reply to their reviews or post an apology. Once you have their written consent, a public response or apology can show others in the forum that you are listening to patients and taking steps to address their concerns. This may turn the negative situation into a more constructive experience.

Posting responses is reactive and shouldn’t be your only strategy for combating negative reviews. Those reviews will live a long time online and could become fodder for malpractice attorneys or could impact your ability to sell your practice.

Instead, be proactive. Consider the patient’s experience and make sure the customer service aspects of your practice meet acceptable standards as part of the new definition of professionalism in medicine. Once you excel in service, encourage more patients to review you online. In the end, any negative reviews will appear to be outliers.

At the end of the day, a negative review is inevitable. Here’s something else to think about: Many people believe that if you have a number of ratings, and only one or two are negative, the ratings overall may be perceived as more credible than if they were uniformly glowing reviews!(3)

Lawsuits Are Not the Answer

Most rating sites have procedures to remove negative reviews if they are found to be fraudulent or otherwise violate a site’s Terms of Service. But the burden of proof rests largely with the doctor. Fighting a negative review can take months of gathering information and negotiating with the ratings site before any action is taken. Unless they find a specific policy violation or fraud, they are unlikely to remove a negative review because doing so would infringe on a patient’s right to free speech.

Some healthcare providers have gone to court over negative ratings that they believe are unfair. This practice is generally not recommended because a lawsuit is not likely to produce a successful outcome. In addition, it is extremely time-consuming and expensive.

As an alternative, doctors and medical facilities have started suing patients to have negative reviews removed — and some have done so successfully. These doctors often have legal teams and the necessary funding to support their fight, so the threat of a suit can be enough to compel the patient to remove a negative review.(4)

Reviews are usually opinions, making defamation suits hard to win. You must establish that untrue statements were made as fact and that those statements hurt your reputation. What’s worse, the case could create a media firestorm in your community or on a regional or national level, depending on the circumstances of the case.

An attempt to censor or remove information online may backfire and instead of being deleted, the information may be shared across the Internet in a very short time. This was the case when Barbra Streisand filed a lawsuit over the online posting of an aerial photo of her house — leading the phenomenon to be known as the Streisand Effect: an attempt to censor or remove information online that backfires and the opposite actually occurs. Instead of being deleted, the situation gets widespread publicity and is often shared across the Internet in a very short timeframe.

Regardless what kind of merit you think a case might have, doctors who sue patients for online ratings are going to lose in the more influential court of public opinion. Better that doctors take some slanderous lumps online and instead encourage more of their patients to rate them. The ensuing positive ratings will drown out any vitriol, making them outliers.

However, resist the temptation to broadcast your positive reviews with abandon. HIPAA rules give patients complete control over how and where their protected health information is used and this law includes anything they write online about their healthcare experiences.

In 2016, a physical therapy practice was fined by a California health agency for posting patient testimonials on its website without the express permission of the patients! If you would like to quote from any reviews you find online, you must get permission first.(5)

Economics of Good Reviews

Research from Harvard suggests there is a real bottom-line benefit to cultivating positive online reviews. The study showed that where Yelp reviews were prevalent in a local market, chain restaurant business declined as consumers gained confidence about the quality of smaller, local restaurants.

This has implications for independent practices in that it may mean that there is an opportunity for small practices to compete against urgent care clinics, hospitals, and other large entities by using an effective online review strategy. It’s a simple and cost-effective way to reach and recruit new patients.

The same survey also found that a one-star rating increase could be directly tied to up to a 9 percent increase in revenue for a small business — another finding that may have implications for healthcare providers.

The other economic benefit of positive online reviews is that it helps the practice maintain overall high ranking in online search results. When reviews are combined with a strong social media presence, good search engine optimization, and an effective website, your practice can quickly rise to the top of the leading search engines like Google, driving traffic back to your website and more patients to your practice.

References

1. Aurora V. from Establishing, Managing, and Protecting Your Online Reputation. Phoenix, MD: Greenbranch Publishing; 2013:30–32.

2. Goldman E. Doctors’ Online Reputation Management and Patient Reviews. Technology & Marketing Law Blog. May 21, 2012. http://blog.ericgoldman.org/archives/2012/05/doctors_online.htm . Accessed August 2, 2018.

3. Segal J. Managing Your Online Reputation. J Med Pract Manage. 2012; 27(6):341–43.

4. Scotti A. Some doctors are suing patients for posting negative reviews about their care online. NY Daily News, July 18, 2018. www.nydailynews.com/news/national/ny-news-doctors-suing-patients-online-reviews-20180718-story.html . Accessed August 2, 2018.

5. Minc A. How Doctors Can Respond to Negative Online Reviews—Without Breaking the Law or Calling Further Attention to Criticisms. Minclaw Blog. January 5, 2018. www.minclaw.com/how-doctors-can-respond-to-negative-online-reviews . Accessed August 2, 2018.

Excerpted from Tweets, Likes and Liabilities: Online and Electronic Risk to the Healthcare Professional by Michael Sacopulos and Susan Gay. https://shop.physicianleaders.org/collections/all/products/tweets-likes-and-liabilities-online-and-electronic-risk-to-the-healthcare-professional