“Online reputation management is becoming more important in our lives as orthopaedic surgeons,” Basil R. Besh, MD, told attendees at the Board of Councilors Board of Specialty Societies Fall Meeting. “My online reputation is vital to the success and the future of my practice.”

Dr. Besh, a hand surgeon in private practice in Fremont, Calif., explained that an online presence is potentially unsettling. “We are online in ways we can control, in some ways that we can’t control, and in ways that we can’t control but we can influence,” he said.

An issue of control
He noted that orthopaedic surgeons can control their own websites, both in terms of content and search engine optimization (which increases the rank of the website so it comes up early when patients search). “You can control mainstream media—every interview you’ve ever given, article you’ve ever published, blog you’ve ever written. You also control your social media accounts, such as Facebook, Twitter, and LinkedIn.

“But you can’t control other people’s accounts and what they say about you on their social media pages,” he noted.

Areas that can be influenced include consumer-generated media, such as online reviews. Up to 80 percent of Americans go online to seek information on health care, including physicians. More than 70 different sites review physicians, and two of them (healthgrades.com and vitals.com) have more than 12 million visits every month.

“We can take steps to influence our online reputations on these sites,” he suggested.

Why is it important?
“Patients are not only going online and reading those reviews, they are also making decisions about which physicians to visit based on these reviews,” said Dr. Besh. “It takes as few as five reviews to influence a patient’s decision.”

Word-of-mouth referrals have always been important to patients; online reviews are simply an extension of that phenomenon. “As physicians, we are interested in protecting our reputations, getting reviews and feedback, and improving the way we do things, including the customer service in our practices,” he noted. “With online reviews, we get to see what patients say along with everyone else. And that can be used to our advantage.”

Heading off complaints
“What we really need is not a single intervention, but a cycle of ongoing management—starting with prevention,” said Dr. Besh. He suggested giving patients a pathway to communicate their dissatisfaction directly, rather than posting it online.

“We have signage in the reception area, our website has an email link for patients to give feedback, and we use both paper and electronic satisfaction surveys,” he said.

Dr. Besh also pointed to the importance of customer service and staff training. “Companies that get high marks on service spend about $5,000 per employee per year on training; the average physician spends less than $200 per employee per year. It’s significant that a disproportionate number of bad reviews come not from the patient’s interaction with the physician directly, but from the patient’s interaction with staff,” he noted.

Dr. Besh suggested training staff to recognize the patient who is upset and putting a mechanism in place to address those issues before the patient leaves the office.

Know what’s being said
Dr. Besh suggested that physicians regularly search their names online and establish search alerts. “It’s pretty simple to do and you’ll get a notification any time there’s a change on the web about you,” he said. “What you can’t do is bury your head in the sand. If you’re too busy, engage a company to do this for you.”

He also advised reading all reviews—including the good ones—and not ignoring the feedback. He gave the example of a patient who compliments the physician’s good bedside manner, saying it offset the 90-minute wait to see him.

“That’s an opportunity to improve processes for the next patient, who may not be so forgiving of long wait times,” said Dr. Besh. “It’s also an opportunity to correct factual data, such as board certification, years of practice, and body parts treated. I updated my data after someone called my hand surgery office asking if I fixed anterior cruciate ligament tears.”

“Fixing” bad reviews
When a patient posts an online review that is less than flattering, Dr. Besh advised, “Don’t rush. Although you don’t want to leave a negative review lingering for patients to see, take your time to verify that the reviewer is an actual patient of yours. One of the only effective strategies for getting websites to remove a review is to prove it is fake. Investigate. Ask your staff about the specific issue.”

He also advised reaching out to the patient. “Patients who are furious online may change when you call to talk to them. Be factual; don’t get into an argument. If you can address their needs, you can ask them to remove the review. Or, they may add an addendum to the review, which is sometimes even more powerful because it shows your responsiveness,” he said.

Many websites provide the opportunity to post responses to negative reviews. “Be factual, stay polite, don’t get into an argument. Be sincere, transparent, and persistent in your response. Do not violate the patient’s privacy,” he advised.

He also provided some creative answers for complaints. For example, if the patient writes, “The doctor seemed rushed,” the physician might respond, “As one of the few specialists in town, we try to serve as many patients as possible.”

Although a lawsuit may be a last resort, Dr. Besh advised against it. “The solution to pollution is dilution, not just in the operating room but online. Encourage satisfied patients to leave positive reviews. This has the dual effect of diluting negative reviews when there are weighted averages and pushing negative reviews down the list.”

Make it easy
To facilitate positive reviews, Dr. Besh provided the following suggestions:

• Encourage patients to post their reviews right at the point of service, using their mobile devices or cell phones.
• As part of a follow-up satisfaction survey, include a link to the review site with a request to leave a positive review.
• Include a link on the practice website to positive reviews.

“You are online—whether you like it or not,” he concluded. “Your online reputation matters. You do have some influence over it, but not complete control.”

Mary Ann Porucznik is managing editor of AAOS Now. She can be reached at porucznik@aaos.org

Bottom Line

• Online reviews of physicians are an important source of information for patients.
• Physicians should monitor online review sites to ensure that the information about them is accurate and to enable them to respond promptly to any negative reviews.
• Because many negative reviews are focused on staff rather than the physician, ongoing customer service training may be helpful.
• Negative reviews should be investigated, positive reviews should be encouraged, and physicians should read and learn from all reviews.

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