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  • Practice Perfect

    How to Protect (and Promote) Your Reputation Online

    By Laura B. Kaufman, Contributing Writer
    Interviewing Tamara R. Fountain, MD, and Andrew P. Doan, MD, PhD

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    Have you ever Googled your own practice? The new patients in your waiting room probably did, and they might have made an appointment only after reading reviews from other patients. “Increasingly, the source of word-of-mouth is online,” said oculoplastics specialist Tamara R. Fountain, MD. “We all have to recognize that our reputations are the most important thing to us, and we need to learn to control our online information as much as possible.” This presents new challenges for practitioners in terms of monitoring and promoting their online reputations. You can get started by taking the following steps.

    First, See What’s Being Said Online 

    When Dr. Fountain first tried Googling her practice, she was surprised by some of what she found. “I noticed that sites like Healthgrades and Vitals already had my data—my medical school, address, and much more. After a bit more sleuthing, I realized that this source of information was something I could control. I took about half an hour, filled in three profiles, and substituted a nice photo for the gray silhouette. That was a good investment of time, as two of the sites have stayed up on the first page [of search results].”

    Steps you can take today. There are three initial steps to take:

    • See what’s being said about you and your practice: Enter your first and last name, along with your medical degree, into a Google search.
    • Fill in your profiles on review sites, and add a professional photo.
    • Set up Google Alerts so that you receive an e-mail every time the Google search engine finds new results that mention you or your practice—such as a new Web page, blog posting, or article.

    Where Patients Go Online

    Some physician-review sites only include ratings; others include patient reviews. “HealthGrades only offers stars, but Vitals, Practice Fusion, ZocDoc, RateMDs, and Medrounds are more comprehensive. Yelp offers just one rating, but a lot of comments,” said Andrew P. Doan, MD, PhD, a comprehensive ophthalmologist.

    These sites are increasingly being tapped anywhere, anytime, by savvy consumers, said Dr. Doan. “Since smartphones and 4G technology have evolved, online searching is extremely fast. Now, a patient can type in your name on the way to your office, or after their appointment, searching for validation of your practice in reviews.”

    More at the Meeting

    Online Reviews Are Driving Me Crazy! (Tech05) Andrew P. Doan, MD, PhD. When: Saturday, Oct. 18, 3:30-4:30 p.m. Where: Technology Pavilion (Booth 165). Access: Free.

    Protect Your Online Reputation (Tech14) Ravi D. Goel, MD. When: Monday, Oct. 20, 2:00-3:00 p.m. Where: Technology Pavilion (Booth 165). Access: Free.

    Protecting Your Online Image (320). K. David Epley, MD. When: Monday, Oct. 20, 9:00-10:00 a.m. Where: Room N427a. Access: Academy Plus course pass required.

    When Reviews Are Negative

    “If you have a few bad reviews, that’s OK,” said Dr. Doan. “It makes you look real. Learn from them—change and adapt.”

    Think twice before responding to a negative review. If you post an online response, “it can look like you are validating the negative review,” said Dr. Doan.

    Dr. Fountain agreed. “Take a deep breath and wait 24 hours. It might be best to rise above it. Most people reading will put the negative review into context. Yelp encourages people to use a rebuttal page, but medicine is held to a different standard. We face potential violations of privacy laws. If the negative comment is about something like wait times, however, it’s great to respond—and do something about it.”

    Don’t take it personally. The catalyst for a bad review might be something that is immaterial to good health care. “If the patient had trouble parking, or the coffee was cold, that could generate a negative review, despite having nothing to do with my quality as a surgeon,” said Dr. Fountain. “Or if you say, ‘You don’t need an antibiotic,’ a patient might leave feeling unsatisfied. That is the weakness of online reviews for medical care.”

    Beware of HIPAA violations. If you do respond to a patient’s review, you cannot reveal any protected information, warned Dr. Doan. “If the patient can be recognized by the way you state your response, it breaks HIPAA.” Dr. Fountain added that “even if a patient puts specific health information in their negative review, you cannot respond—it is a violation to do so without permission.”

    Let patients vent offline. Providing patients with paper surveys can give them an opportunity to get something off their chest. “They just want to be heard,” said Dr. Doan. “As soon as they release that stress, they’re done.”

    When Reviews Are Unjust 

    Let’s say you have an unfair comment posted about your practice on Yelp from a disgruntled patient, an employee, ex-employee, or competitor. What can you do?

    According to Dr. Doan, very little. “You have to hire a lawyer, and typically, a site such as Yelp doesn’t own the review, the person who posted the comment does. You can spend a lot of time and money to try to contact that person and request they remove the review. It may or may not work.”

    When a patient posts a comment that you feel is unjustified, you may be tempted to post a response. “But be very careful, as this could make things worse,” said Dr. Fountain. “And if you want to file suit, it is generally an uphill battle, as a malpractice carrier is not going to cover you for this type of legal procedure. And a long fight could generate more [negative] Google information. So, even if you win, you could lose.”

    Dr. Fountain said that some websites allow you to challenge the comment. Websites have policies for how they research and vet comments, and if you really feel that something about a comment isn’t right, for instance, you think it is from a competitor, there are ways that a website can confirm the commenter’s identity, she said.

    Dr. Doan experienced a negative review before he even opened the door to a new practice. “We knew it had to be a competitor,” he said. After a lengthy battle attempting to prove that the person who posted the “patient’s review” wasn’t actually a patient, the review was taken down. Drawing on this experience, he and some colleagues started a company, Verified Reviews, to help physicians proactively capture their own patient reviews.

    Boost Positive Reviews

    With enough positive reviews, you can bury any negative ones, said Dr. Doan. Dr. Fountain agreed: “You can ask your patients for honest feedback and ways to improve, as well as to review you on rating websites. I like to separate myself from the actual solicitor, so our office manager sends out postcards. The wording can be something such as, ‘Increasingly, patients are turning toward the Web for their health care providers. Please help us evaluate our practice by leaving some comments.’ Maybe 1 in 10 will do it, but that could still generate a lot of online comments. The vast majority of our patients are satisfied with the care they receive. If we simply ask, we are likely to get positive feedback.” 

    Asking for comments “dilutes down the negative, and you may also make practice improvements,” said Dr. Doan. “If you don’t manage your online reviews, you’ll end up with only a small minority of patients online— and they may have an axe to grind. In medical school, we were taught that with an infection, the key to pollution is dilution. This can be seen that way: The solution is not to hire lawyers, but to dilute the naysayers.”

    ___________________________

    Dr. Fountain is an oculoplastics specialist at Ophthalmology Partners in Deerfield, Ill., and a professor of ophthalmology at Rush University in Chicago. Financial disclosure: None. Dr. Doan is a comprehensive ophthalmologist at Eye Associates of Southern California in San Diego. Financial disclosure: A founder of Verified Reviews, a company that provides a review system for online reputation management.

    OMIC Forum at AAO 2014

    Can more be done with training to enhance patient safety and minimize the risk of adverse outcomes? Ajit K. Sachdeva, MD, FRSC, FACS, will tackle that question during the Bruce E. Spivey, MD, Lecture in Risk Management and Patient Safety—Transitions, Vulnerabilities, and Patient Safety. “A culture of continuous learning needs to be established within health care organizations, and innovative approaches should be used to achieve the best results,” said Dr. Sachdeva, who is the founding director of the Division of Education at the American College of Surgeons.

    Following that lecture, the 2014 OMIC Forum is a fast-paced session that will provide risk management pearls for some key liability issues.

    When: Sunday, Oct. 19, 2:00-3:00 p.m. (Bruce E. Spivey, MD, Lecture) and 3:00-4:00 p.m. (OMIC Forum). Where: Room S406b. Access: Free.