Deal­ing with on­line rat­ings of­ten proves chal­leng­ing for doc­tors

Modern Healthcare - - NEWS - By Sabriya Rice

Much as they might re­search restau­rant re­views, health­care con­sumers in­creas­ingly are seek­ing physi­cian rat­ings on­line, and some ex­perts say doc­tors should em­brace the trend rather than fight it.

A re­port pub­lished re­cently in the Jour­nal of the Amer­i­can Med­i­cal As­so­ci­a­tion found that 65% of sur­vey re­spon­dents were aware that on­line physi­cian rat­ings ex­isted. Among those who used the sites, 35% re­ported se­lect­ing a physi­cian based on good re­views, while 37% avoided a doc­tor based on bad re­views. How­ever, some 43% of sur­vey re­spon­dents re­ported a “lack of trust” in physi­cian- rat­ing sites, and many still pre­ferred word-of­mouth re­fer­rals from fam­ily and friends.

Nev­er­the­less, use of on­line rank­ings is only go­ing to grow in pop­u­lar­ity, said Dr. David Hanauer of the Univer­sity of Michi­gan Med­i­cal School, who coau­thored the re­port.

“Health is too risky and too ex­pen­sive for con­sumers to not ver­ify,” said Dr. John Santa, med­i­cal di­rec­tor of Con­sumer Re­ports Health, which pub­lishes ob­jec­tive hospi­tal qual­ity mea­sures for con­sumers and is work­ing to pub­lish qual­ity data on in­di­vid­ual prac­tice groups. In con­trast, user-re­view web­sites such as Yelp and Angie’s List let con­sumers of­fer sub­jec­tive com­ments on in­di­vid­ual doc­tors.

Ob­jec­tive data and sub­jec­tive re­views are im­por­tant from a con­sumer per-

“Health is too risky and too ex­pen­sive for con­sumers to not ver­ify.” —Dr. John Santa, med­i­cal di­rec­tor of Con­sumer Re­ports Health

spec­tive, Santa said. “Our read­ers or­ga­nize their thoughts around com­par­isons. Pa­tient ex­pe­ri­ence and sat­is­fac­tion is an im­por­tant part of that.”

More than 40 web­sites al­low In­ter­net users to re­view their health­care providers, ac­cord­ing to a re­port pub­lished in 2013 in Case Western Re­serve Univer­sity’s Jour­nal of Law-Medicine. But many physi­cians are re­luc­tant to ac­cept the trend. Of more than 700 doc­tors sur­veyed last year by the Amer­i­can Col­lege of Physi­cian Ex­ec­u­tives, only 21% be­lieved that more than half of U.S. pa­tients con­sulted an on­line rat­ing site. Even so, 69% of sur­veyed physi­cians ad­mit­ted to check­ing out their own on­line profiles.

Some doc­tors have filed law­suits when they didn’t like what they read. In Bos­ton last year, a sur­geon sued the fam­ily of a pa­tient who posted an­gry com­ments in a per­sonal blog; the sur­geon al­leged defama­tion and de­manded dam­ages. A Santa Clara (Calif.) Univer­sity re­port last July listed more than 30 cases of doc­tors fil­ing sim­i­lar law­suits fol­low­ing neg­a­tive on­line posts to sites such as Face­book, Yelp and RateMDs. Many of the suits were dis­missed, ac­cord­ing to the re­port, of­ten as a re­sult of anti-Strate­gic Law­suits Against Pub­lic Par­tic­i­pa­tion laws, which pro­tect free­dom of speech.

Some ex­perts say le­gal ac­tion should not be a doc­tor’s first re­sponse. “View­ing the law as a way of deal­ing with this is very short­sighted,” said David Ar­dia, co-di­rec­tor of the Univer­sity of North Carolina Cen­ter for Me­dia Law and Pol­icy. Rather, doc­tors should re­gard these sites as po­ten­tial op­por­tu­ni­ties to com­mu­ni­cate ex­cel­lence, he added.

First, doc­tors should dif­fer­en­ti­ate opin­ion from false fac­tual state­ments on these sites, said Ron­nie Dean, vice pres­i­dent of sales and mar­ket­ing for Med­i­cal Jus­tice, a group that works with doc­tors on med­i­cal-le­gal mat­ters. He rec­om­mended writ­ing a diplo­mat­i­cally worded note to the web­site’s ad­min­is­tra­tor, ask­ing the site to con­sider whether a par­tic­u­lar post com­plies with its terms of use poli­cies.

“Do not sweat an iso­lated neg­a­tive re­view,” he ad­vised. “The pub­lic un­der­stands you can­not make ev­ery­one happy. But the pub­lic also ex­pects you will make most pa­tients happy.”

An­other con­sul­tant urges doc­tors to con­tact site posters di­rectly if pos­si­ble, ac­knowl­edge the pa­tient’s is­sue, and of­fer to rec­tify the sit­u­a­tion if ap­pro­pri­ate. The goal is to get a pos­i­tive up­date from the con­sumer, said Gary Truitt, founder of Fat Brain In­ter­ac­tive, which helps health­care providers man­age their on­line pres­ence.

Both Dean and Truitt sug­gested that doc­tors es­tab­lish their own on­line sys­tem for seek­ing feed­back from pa­tients, es­pe­cially those who have had a pos­i­tive ex­pe­ri­ence. “You have to be dili­gent in ask­ing your pa­tients for on­line feed­back,” Dean said. Then, when the in­evitable neg­a­tive re­view does sur­face, “it will be placed in con­text of the mul­ti­tude of pos­i­tives.”

Fi­nally, an apol­ogy in ap­pro­pri­ate sit­u­a­tions goes a long way, Dean said. He cited a case where a sur­geon mis­tak­enly per­formed a tummy tuck in­stead of li­po­suc­tion, and the pa­tient ripped the physi­cian on­line. The sur­geon re­sponded by re­fund­ing the fee and of­fer­ing fi­nan­cial as­sis­tance dur­ing the pa­tient’s re­cov­ery.

“When all was said and done, that pa­tient re­canted the slam, re­plac­ing it with a nar­ra­tive of the physi­cian’s sup­port­ive ac­tions,” Dean said.

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