How Physicians Should Deal With Online Rating Websites

Many of you may be tempted to ignore what patients are writing about you online. After all, actively monitoring rating and review websites will take up more of your already limited time and energy. Plus, there's the fear of what you might find. Reading negative comments about yourself and your practice is probably not your idea of a good time.

But experts say that in the case of online ratings and reviews from patients, ignorance is not bliss. The more aware you are of what patients are writing about you, the more able you will be to improve your online reputation.

That online reputation may be playing a bigger role in your practice's well-being than you think. Take Los Angeles-based solo OB/GYN David Ghozland as an example. He says 50 percent of his new patients point to online reviews and rating sites, such as Yelp and ZocDoc, as their referral sources. "... Where once our referrals were in large part from other physicians, we find that our biggest referral basis today is the online referral," he says.

While your practice may not have experienced such a dramatic shift in referrals, it's likely that online ratings and reviews are playing a bigger role in your ability to attract new patients.

A 2012 survey of more than 2,000 individuals found that 59 percent considered online reviews and ratings at least "somewhat important" when choosing a new doctor; and nearly 25 percent had actively sought out physician ratings when choosing a primary-care physician in the previous year. The survey findings appeared in a recent JAMA article based on research from the University of Michigan Health System, School of Public Health, and Gerald R. Ford School of Public Policy. Another survey, conducted by healthcare technology company Digital Assent in 2013, found that 72 percent of 341 respondents said that bad reviews would prevent them from going to see a particular doctor.

Given the growing role online ratings and reviews are playing in new patient acquisition, it's time to take a more active role in managing your online reputation. But it can be difficult to determine how to begin. To help, we asked online reputation management experts to weigh in. Here are five simple steps you can take today to ensure the first impression you give online is just as great as the one you give in person.

Step 1: Claim the listings

While only a small percentage of patients are actively rating and reviewing their doctors online (10 percent according to a 2013 survey of more than 4,500 patients conducted by software consultancy Software Advice), nearly all potential new patients are exposed to such ratings, says Laurie Morgan, partner and senior consultant at practice management consultancy Capko & Morgan. That's because whenever an individual types a physician's or practice's name into an Internet search box (after he finds that the physician is an in-network provider on his insurance plan; or when he is trying to find a practice's phone number to set up an appointment), online ratings and reviews tend to sit at or near the top of the search results. Sometimes, Morgan says, they outrank even a practice's own website.

For that reason, the first step to take better control of your online reputation is determining what patients are exposed to when they search for you online. Family physician Michael Woo-Ming, founder of RepMD, a medical marketing consulting firm, recommends typing your name and/or your practice's name into Google, as this is the most popular search engine. Then, scroll through the first and second pages of results.

The results are likely to include links to listings on popular rating sites such as Healthgrades, Yelp, and Vitals; as well as a Google listing that might display a map to your practice, and ratings and reviews pulled from various physician rating sites, says Morgan. Similar to a profile of you or your practice, the listings on these sites tend to include your practice address, phone number, insurance accepted, as well as ratings and reviews.

Once you identify on which sites your practice is listed, visit each listing and look for a link that will enable you to log in and "claim" the profile, says Morgan. On Healthgrades, for instance, a link on the upper right-hand side of the page says, "Doctors: Update Your Free Profile." When you click on the appropriate link on each site, you will likely need to provide some specific information, such as your address or phone number, so that the site can verify your identity.

Step 2: Correct, update, and monitor

Claiming your listing will enable you to fix any factual errors on the site; for example, an incorrect address. You may also be able to add information to the listing, such as your practice's phone number. Since many patients use these sites as "information directories," try to add and correct as much information on your listings as possible, says Parham Javaherian, CEO of Practice Builders, LLC, a healthcare marketing firm. If your phone number is listed incorrectly, for instance, that could deter a potential new patient from setting up an appointment.

A good place to start the process of updating and adding to your information is with the Google listings that crop up, such as Google+ or Google Places, as they tend to be quite prominent in search results. Morgan recommends adding as much as you can to the listings, including photos of your practice and a short description. "You can make it almost like a miniature website of your practice ... and then that really helps you stand out within Google," she says. Also, note which rating sites the Google listing is pulling its reviews and ratings from, and make sure you claim your profiles on those sites.

Once you claim your listings, many of the rating and review sites will send you e-mails whenever a new comment or review is posted, says Morgan. That will help you monitor what patients are writing about you online.

Also, set up Google Alerts (alerts.google.com) for your name and your practice's name, says Woo-Ming. Whenever those keywords are mentioned online, Google will e-mail you a link to the content.

Step 3: Build it up

After you claim your listings and begin monitoring your reputation, it's time to start cultivating it. While you should never "plant" positive reviews about yourself, or your practice, it's perfectly appropriate to encourage your patients to review you online.

This is something Ghozland does when he notices that patients are particularly pleased with the care he provides. "To ask patients to review you online takes a few seconds - and they'll do most of the work," he says. "When you ask them, they really take it to heart and want to do it for you, and that goes a long way. The more positive reviews you have from patients describing their experiences, and why they like you, the more likely somebody's going to come to see you."

To increase the likelihood that a patient will review you, Michael Fertik, founder and CEO of Reputation.com, an online privacy and reputation management services company, recommends making it as easy as possible. For instance, place a kiosk computer in your reception area for patients to provide a review as they check out; or, send patients an e-mail after they leave your practice inviting them to review you online. "It's not about incentivizing people," says Fertik. "It's just about making it easy."

If you're not comfortable asking patients directly for reviews, there are subtler options, such as posting signs at your front desk inviting patients to review you online.

Step 4: Plan for the worst

In addition to encouraging positive reviews, do all you can to discourage negative ones. Woo-Ming recommends asking patients to fill out short comment cards after each visit. That way you will be more aware of areas you need to improve; and patients will be less likely to go home and air their frustrations publicly because you have already given them an opportunity to vent.

Despite your attempts to mitigate negative reviews, however, they may crop up occasionally. Unfortunately, there's no foolproof method for handling them, and even our experts were divided on the best approach.

Fertik says you should ignore negative reviews unless they contain "demonstrably" incorrect information or accusations. "If they say, 'Look, you only have one doctor working on premises with no back up,' and you in fact, have four doctors, you may just want to politely point that out," he says. "But you don't want to get into a shouting match, even with someone who's completely full of it. You just want to focus on the demonstrably, provably, false stuff, if you say anything at all."

Woo-Ming suggests a more proactive approach. If you are able to determine which patient wrote the review based on the context of it, he recommends contacting the patient privately. If the patient confirms that she wrote the review, apologize for the problem that led to her frustrations, and try to work toward a solution. You may be able to mend your relationship with the patient, and she may decide to remove the poor review from the site, if she is able, says Woo-Ming.

If you are unable to determine who wrote the review or get into contact with the patient, Woo-Ming recommends posting a non-confrontational reply apologizing for the patient's frustrations and asking him to contact your practice so you can fix the problem. "People understand that if you have a busy practice you're going to upset a few people down the way, but they'll actually have a greater respect if you actually show that you've taken the time to respond to their comments," he says. For five of Woo-Ming's tips on how to reply to negative reviews, visit bit.ly/review-responses.

Regardless of the approach your practice chooses to take when patients post negative reviews, there are three rules that all practices should follow:

1. Don't expose protected health information. If you choose to respond to a review, never reveal personal information about the reviewer. Also, avoid confirming that the reviewer is your patient, says Woo-Ming. For instance, start off your reply with something like: "If you do happen to be one of our patients ..."

2. Don't take abuse. If a review is wildly off base, such as an accusation that you or your practice has engaged in criminal behavior, ask the rating site to remove the material, says Woo-Ming.

3. Don't panic. One negative review won't necessarily ruin your online reputation, especially if the majority of your reviews are positive, says Morgan. In fact, a negative review might actually lend the rest of the reviews more credibility, because patients won't feel like they have been "planted" by your practice, she says.

Step 5: Embrace other avenues

Don't focus solely on online ratings and reviews when attempting to build up your practice's online reputation. A strong website and social media presence are also important, says Javaherian. Even better: The content that appears on these sites and pages is entirely in your control. So take advantage.

Javaherian, who recommends engaging in at least two forms of social media, says your website and social media pages should have consistent branding (such as your practice logo), creative imaging (including photos of your practice), and unique copy (the text should not be duplicated from another website or template). This will help your website and social media pages show up higher in search results.

Ghozland, whose practice is active on Facebook and Twitter, posts health-related articles and practice news on his Facebook page. He also encourages patients to share pictures of the babies he has recently delivered. "[Practices] have to understand that if they're not embracing the Internet today they're actually doing themselves a disservice, and that it takes time," he says. "You're not going to see results right away; it takes a few months for things to build up. [I would say] not to get discouraged but to keep at it, and to find a point person for it so that it doesn't get lost in the shuffle."

The root of poor reviews

When it comes to online ratings and reviews, poor customer service is more likely to get you in trouble than the clinical aspects of a patient's care.

A multi-city study based on 3,716 online reviews appearing on rating websites Vitals, RateMDs, and Yelp found that unhappy patients who posted negative reviews complained about poor customer service and bedside manner four times more often than those who cited misdiagnoses and inadequate medical skills. The study was conducted by medical marketing research firm Vanguard Communications.

Reviews raise risks

Negative online ratings and reviews from patients may dissuade potential new patients from visiting your practice. But they also might raise legal problems.

When a patient presents a malpractice allegation to an attorney, that attorney may Google the physician, says Michael Woo-Ming, founder of RepMD, a medical marketing firm. The results that crop up from online ratings and review sites may have a big influence on the attorney's next moves.

"I've actually been talking to malpractice attorneys and they can definitely see if there are some doctors who have a pattern of poor performance," says Woo-Ming. "It can definitely influence whether or not they decide to take a case or look at a particular angle of how they want to approach a case."

In Summary

Taking a proactive approach to online ratings and reviews does not need to take up a lot of your time and energy. Here's how to get started:

• Google your name and your practice's name to see which rating sites you are listed on.

• Claim the listings on the sites and update the information.

• Set up Google Alerts to monitor when your practice is mentioned online.

• Encourage happy patients to post online reviews.

• Build up your website and social media presence.

Aubrey Westgate is senior editor for Physicians Practice. She can be reached at aubrey.westgate@ubm.com.

This article originally appeared in the June 2014 issue of Physicians Practice.