Shirley S. Wang
Updated June 25, 2017 11:59 p.m. ET
When Basil Besh, an orthopedic hand surgeon based in Fremont, Calif., decided in 2009 to start his own surgery center, he knew he had to have a strong presence on the web to be competitive.
He set up a Google alert to tell him whenever his name was mentioned and signed up for a service run by Empathiq, a health-care-focused online reputation-management service, that monitors his online reviews on rating sites such as those run by Healthgrades Operating Co. and Yelp Inc. He routinely reads his reviews and calls patients who express dissatisfaction to find out what if anything he can change. This has led him to make improvements to his practice, says Dr. Besh, and to a 4.5-star rating (out of 5) on Yelp.
It is standard practice for large and small businesses to closely monitor their online reputations, and now more services are helping doctors, clinics and hospitals do the same. In addition to monitoring reviews and ensuring accuracy about the details of the practice, some of these firms will solicit patient reviews and generate other positive content to push down negative press in web-search results. Some also help their clients contact patients to address their concerns and ask them to change their reviews.
Bad online ratings can wreak havoc on doctors’ businesses, in extreme cases driving physicians to leave a particular state to practice elsewhere, according to doctors and reputation-management companies. Ratings sites will take down reviews that use profanity or can be proven fake, but they typically won’t edit or remove a review simply because a doctor (or any business) disputes what is in it.
And unlike restaurants or plumbers, doctors can’t change their company name if their reputations are damaged.
But doctors and reputation-management firms say paying close attention to reviews and other feedback doesn’t just benefit doctors; consumers also benefit if doctors make changes that result in a better patient experience.
More than 70% of consumers search for health information online, according to Pew Research Center, and 77% of consumers say they use online reviews as the first step in finding a new physician, according to a 2015 survey of 1,438 patients by Software Advice, a software research and advisory firm.
Andrea Pearson, chief marketing officer at Healthgrades, one of the largest rating sites for doctors, with one million visitors a day, says reputation-management firms can play a beneficial role by increasing the volume of feedback from patients—but only if the reviews are truthful and come from real patients. (Healthgrades has several checkpoints in place to help it verify the authenticity of reviewers, she says.) Still, she says most physicians will find these firms’ offerings are limited, and will have more success when they work directly with the online sources themselves.
Others are more critical of any practice that attempts to skew consumers’ impression about a business.
“Reputation-management firms are paid to make their clients’ online image as flattering as possible,” says Luther Lowe, who heads public policy at Yelp. Doctors, like other business owners, are able to respond to reviews, including negative ones, he says, adding that Yelp sees more failed attempts to mislead consumers with fraudulent positive reviews than it sees failed attempts to malign competitors with fake negative reviews. Yelp, he says, has several technologies in place to detect and pull down fake reviews.
Reputation-management firms say patient-confidentiality rules mean physicians have to be more careful than other businesses in how they respond to negative reviews and complaints online. For example, if a patient says a doctor missed a particular diagnosis, physicians can’t publicly dispute the patient’s claim because it would violate confidentiality. Instead, doctors are encouraged to respond generically to the review online and ask the patient to contact the practice for a more specific response.
Banner Health, a large integrated health service employing or affiliated with 9,000 doctors, monitors its online reviews through Reputation.com of Redwood City, Calif. Soon, Banner will start using natural-language recognition technology to analyze online comments on Facebook and other social-media sites and reroute negative feedback into its call center, a service provided by Salesforce.com . The software will divide comments into positive, neutral and negative buckets, and the negative comments will be monitored continuously during business hours. Complaints that require action will be issued a trouble ticket, just as if a patient had called the call center directly. For instance, if a patient is in the emergency room and complains about a long wait, Banner may send a staff member to apologize and give them a coffee, says Alexandra Morehouse, chief marketing officer of Banner.
The health system also solicits phone- and email-based patient-satisfaction scores directly and will have doctors call patients to discuss negative reviews. “One woman hung up three times because she didn’t believe the doctor would call” about a review, says Ms. Morehouse. The doctor eventually connected with her and was able to clear up a miscommunication, she says.
IHealthSpot, another reputation-management service used by health-care professionals, builds separate websites called microsites that are embedded in its clients’ pages. These microsites pull in reviews from ratings sites and the web but display only those that are three, four or five stars—effectively hiding the most negative reviews. The microsites also provide an overall rating based on that subset of reviews.
“From our perspective, there are often reviews on sites that are unfair, [yet] you can’t get them removed,” says Mary Hall, iHealthSpot’s chief executive. “We’re not getting rid of the bad ones, just highlighting the best ones. It is a bit of a gray area.”
Carolyn Murray, who owns a medical weight-loss clinic called Physicians Weight Loss Centers in Columbia, Md., says she turned to iHealthSpot a few years ago when a prospective patient wanted to cancel her appointment after seeing a negative review about the clinic on Yelp.
The review was left by an unhappy patient who had missed several appointments without canceling and wanted her visit fee back even though the cancellation policy stated she would forfeit it, says Ms. Murray, who isn’t a physician herself but employs one in the business.
Another negative Yelp review described a patient experience that clearly didn’t happen at her clinic, she says. Ms. Murray says she appealed to Yelp, which declined to take down the reviews, saying she could respond to them if she wanted. Yelp declined to comment.
Ms. Murray says that employing a reputation-management firm has been helpful because she now knows when patients leave reviews, good or bad, and can respond to them quickly. But she is frustrated that people can say whatever they want about her clinic even if it isn’t truthful. She says that several patients have threatened to leave bad reviews if they don’t get their money back.
The clinic has an average 2-star rating out of 5 on Yelp, based on eight reviews, and a 3.7-star rating out of 5 on Google, based on 15 reviews. The microsite on her clinic’s website, however, lists a 5-star average patient rating, with most of the reviews coming from Google.
Ms. Murray says she believes the microsite reviews “are helpful, not misleading, because a lot of the negative reviews are incorrect.”
Most doctor reviews are positive, according to industry research. About 75% of the time, negative reviews of doctors and clinics are about things like wait times, grumpy receptionists or parking—things can easily be addressed, those in the industry say. The other complaints tend to center on the physician’s bedside manner, confusion about treatment or follow-up care, or lack of follow-up. Only occasionally do reviews state that a doctor treated them incorrectly, they say.
Dr. Besh, the California hand surgeon, learned from reading a review that patients were waiting a long time to see him. He reduced wait times in part by emailing forms in advance through a patient portal.
At the same time, “there’s a price to be paid for that—what patients want versus what patients need,” he says. For instance, a patient once wrote a negative review because Dr. Besh refused to order an MRI. “We work by guidelines, and the MRI wasn’t warranted,” he says. But “I can see how a doctor could say we’re going to order MRIs on everyone” so they won’t get bad reviews.
“Online reputation review is really a double-edged sword,” says Dr. Besh.
Appeared in the June 26, 2017, print edition as ‘When Doctors Get Negative Reviews Online.’