Online Reputation Management @ American Academy of Orthopedic Surgeons on 9/20/2014
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Slides from Dr. Basil Besh's speech at the American Academy of Orthopedic Surgeons fall meeting in Nashville on 9/20/2014. The slides cover the state of online reviews and how they affect a doctor's reputation. At the end of the presentation, options are explored for influencing reviews by responding to and getting more of them. Dr. Besh is the Medical Director of FORM's (Fremont Orthopaedic & Rehabilitative Medicine) Hand, Wrist & Elbow Institute. Dr. Besh is known his expertise in the field of hand surgery and excellent ability to communicate with patients and fellow doctors. Review Concierge thanks Dr. Besh for being a client and for allowing us to share this presentation with doctors around the country. For more information about Dr. Basil Besh, visit http://www.drbesh.com For more information about Review Concierge, visit http://reviewconcierge.com
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Online Reputation Management @ American Academy of Orthopedic Surgeons on 9/20/2014
- 1. Basil R. Besh MD Surgery of the Hand, Wrist, and Elbow Fremont, California
- 2. I have an online reputation. I care about my online reputation. My online reputation is vital to the success and future of my practice. No other disclosures.
- 3. What is online reputation management? Why is it important? What can you and can’t you do about your online reputation? What are some emerging trends to keep an eye on?
- 6. Instagram
- 8. Ways we control. Ways we can’t control. Ways we can influence.
- 9. Your Website (content and SEO) Mainstream media Interviews Publications Blogs Social Media Facebook, Twitter, LinkedIn (your sites)
- 10. Other people’s accounts Twitter Facebook Instagram
- 11. Consumer generated media (online reviews) Generic Yelp Angie’s List Healthcare specific RateMD Healthgrades Vitals
- 12. 1999 – RateItAll.com, Deja.com, and Epinions.com By January 2000, 1,146,201 reviews Doctors not reviewed until 2004 RateMD.com April 2004 – 320 ratings June 2007 – 534,999 ratings 2008 Healthgrades.com and Vitals.com launch Today 11.6 million people visit the two sites each month
- 14. 50% increase year to year!
- 22. Give patients an easy pathway to communicate dissatisfaction. Signage in waiting room. Email link on website Satisfaction surveys
- 23. Don’t ignore upset patients. Staff training for customer service. Recognition of upset patient.
- 24. Not a good idea. Sacrifices good will and positive public image for the practice Unenforceable.
- 33. Read all the reviews, including the good ones. Look for red flags. Look for opportunities for improvement.
- 34. Update NPI data!
- 38. Don’t rush Verify Investigate Reach out Be factual Ask nicely
- 39. Look inward!
- 40. Stay factual. Stay polite. Don’t get into an argument. Be sincere, transparent and consistent. Don’t violate privacy rights.
- 41. “The doctor seemed rushed.” “As one of the few specialists in town, we pride ourselves in serving as many of as our patients as possible.”
- 42. Short answer is probably not. Communications Decency Act of 1996 prevents suing the site. Dr. Tuli v. Fotour or Dr. Gesquiere v. Puttman
- 43. Encourage satisfied patients to post positive reviews. Dilutes negative reviews. Pushes them down the list.
- 44. Avoid reviews being deleted. Don’t have patients leave reviews from your office computers IP addresses and cookies will lead to deleted reviews. Have them use mobile devices or email link to patients.
- 45. Complex proprietary algorithm. Attempts to prevent fake reviews. Make it work for you. Cut and paste to your website!
- 48. Includes patient satisfaction Imperfect methodology Government-sanctioned increase in spending and mortality.
- 52. You are ONLINE! Your online reputation matters. You have some “influence” over it. There are some “interesting trends” on the horizon.
Editor's Notes
- Thank you Larry for that incredibly gracious introduction. As Larry mentioned, I’d like to speak to you today about what I feel is becoming a progressively more important topic in healthcare, namely online reputation management.
- I have an online reputation, I care about my online reputation, my online reputation is vital to the success and future of my practice. I have no other disclosures.
- We will spend some time today discussing what online reputation management is, why it is important, what you can and can’t do about it, and what are some of the emerging trends to keep an eye on in the future.
- A wise man once said “Anything that is already in the world when you were born is just normal.” We certainly don’t consider telephones, or televisions, or cars to be modern technological marvels.
- “Anything invented between when you were born and when you turn 30 is exciting new technology and represents a potential opportunity. “ Things like computers, and the internet, and cell phones while potentially foreign to our parents generation, are an integral convenience in our everyday lives today. It’s hard to imagine that the iPhone is celebrating it’s 7th birthday this year. They grow up so fast!
- But anything invented after you turn 30 is against the natural order of things and is the beginning of the end of civilization as we know it . . . until it’s been around ten years or so, then we can proceed cautiously. Well that’s kinda where we are with some of this newer technology such as facebook, twitter and instagram. . . And it can be somewhat unsettling. Now to Fred Azar’s credit, as he pointed out to me at the Western Orthopedic meeting a month or so back, he’s just figured out the difference between tweeting and twerking, so I believe there is hope for all of us.
- And I would argue that us having a presence online for our generation represents just that, a new technology that is potentially unsettling for the vast majority of us. The problem is, whether we like it or not, we ARE ONLINE!
- In what ways are we online? Well for organizational proposes, we can divide into three categories, ways we can control, ways we cannot control, and ways we can influence? And I think that it is this third category that represents the most opportunity.
- What are the ways we can control? Your website, which you can control both in terms of content as well as search engine optimization. Mainstream media, which includes every single interview you have give, every article you have published and every blog you have written. Finally social media, so long as we are talking about your own accounts, such as your facebook account, your twitter account, or your LinkedIn account.
- SO just a brief history of online reviews. In 1999, shortly after the impeachment trial of Bill Clinton was dismissed by the Senate, three websites—RateItAll.com, Deja.com, Epinions.com—appeared on the internet1 and set in motion a social trend called “online reviews” that influences nearly every type of consumer purchase today including choosing a doctor. Within one year there were over a million online reviews. The first healthcare specific website, RateMD, came about in 2004 and went from 320 ratings in its first year to over half a million ratings it’s second year. By 2008, several more sites had sprouted up, including healthgrades and vitals. Within six years, there are nearly 12 million people visiting the two sites each month.
- It’s been estimated that there are now over 70 sites for reviewing physicians, all trying to drive traffic to their sites because their business model is they make money by selling advertising dollars.
- Are online reputations important in patients making selections? Yes they are and the importance of online reputation is increasing. The effect of both positive and negative reviews on a patients’ decision making is increasing over time and the percentage of folks who either don’t look at online reviews or who choose to ignore them is steadily decreasing. In a bit we are going to see how we can use this to our advantage.
- And it doesn’t take many reviews to influence the average patient in terms of their decision to come see you. In our world of science, we would never base a treatment decision on a study with such a small sample size, and yet a patient will choose or not choose a doctor even when fewer than five reviews exist. And of course, fewer reviews has the added complexity of increasing the weight of each individual review when a patient is only looking at the average rating. In a bit, we are going to talk about how we are going to use this to our advantage as well.
- The bottom line is that patients are selecting their physicians in this imperfect system.
- So online reputation management is controlling, or at least attempting to control, how you appear on line when people search you. And this wasn’t written by some solo private practioner. This was written by the senior social media strategist for a major hospital system.
- Well I would argue that this really not that different than things used to be, only the medium has changed. Ideally this is what you would like to accomplish, essentially a cycle where we are constantly monitoring how we are doing by both internal and online reviews and feedback, making the necessary improvements, which in turn result in increased satisfaction, better reviews and greater demand for our services. So how do you do this?
- Some people are going to like you and some aren’t. The problem now is that the medium for conveying these opinions has changed. It’s no longer word of mouth, it’s a medium with much broader penetrance.
- Well, when it comes to managing your online image, you need an ongoing strategy, not a one time intervention. This involves addressing prevention, monitoring, analysis, and mitigation in an ongoing fashion. I’ll try to go over some Do’s and Don’ts in each step of the way. I would like to have this image divided into four sections which pop out one at a time so I can go into each section individually beginning with prevention.
- Another preventative measure is to create an environment that encourages patients to give feedback right then and there. Give patients an alternative pathway to complain, either in the office or even on your website rather than heading to the internet to flame you. We give multiple avenues for dissatisfied patients to reach out to us including a number they can text, a suggestion box, feedback questionairres and a link to a feedback section on our website. Don’t ignore the upset patient. In my office, we’ve designated our office manager as the “soother”. Staff is trained that once they see the red flags of a patient getting upset, they get the office manager to come and speak to patient. I give her broad latitude to make the patient happy, including adjusting bills.
- Some of us are thinking, “you know what, this is stupid. I’m not engaging in this nonsense. I’ll just have patients sign an agreement not to review me online at all if they want to be treated by me.” Not a good idea for several reasons. First of all, it is essentially unenforceable. More importantly, you potentially sacrifice the good will and positive public image of your practice.
- Or even worse. There was a company a few years back called Medical Justice which would help physicians develop a “not to review” contract for their patients to sign. The contract was written under the auspices of “Mutual privacy” There was a case in New York that led to a class action law suit by a patient against a dentist who used these contracts and the company that helped him write the contract. That company has since ceased this particular line of business. Bottom line, bad idea.
- Now if you are in California, and this is hot off the presses, these non-disparagement agreements are not even an option anymore. Just last week, our own Governor Jerry Brown signed AB2365 which bans such agreements.
- Let’s move on to monitoring.
- If you haven’t googled yourself yet, please do.
- Set up a google alert for your name. It’s free and easy. A google alert will email you anytime there is a change in your online presence, for example a new review. Make sure you address various spellings. Use your initial name search to guide how you set up your alert.
- Now far be it from me to give busy orthopedic surgeons one more thing to have to mind. You can also outsource this to various companies. Some are dedicated to the online reputation component while others included it as a service line in their broader marketing offerings.
- Moving on to analysis . . . .
- . . . . analyze what you find critically. Read ALL the reviews, including the good ones. Read good reviews and look for worrisome trends. The patient may like you so much that they may be willing to overlook surly staff or long wait times, but the next patient might not be so gracious. Always be looking for opportunities for improvement even in the good reviews
- And as we said earlier, on sites that have a section that posts factual data in addition to user reviews, such as healthgrades, make sure the data are correct and update them as needed. . Also, take the opportunity to update your NPI info since this is where most websites derive factual data about you.
- On to mitigation . . .
- While the vast majority of patients love you as was previously discussed, unfortunately not everyone does.
- And sometimes they dislike you enough to take to the internet and leave you a bad review and the question becomes “What now?”
- While you don’t want a negative review to linger, don’t panic or rush. Take your time and do your due diligence. Verify the identity of the reviewer. Confirm that this is actually a patient. Ask your office staff if there were any incidents with this patient that stand out. Contact the patient and let them vent. Be empathetic. Be respectful. Don’t get into an argument. Try to stick to the facts See if they are willing to retract the review or add an addendum.
- Look inward. Our natural instinct is to dismiss the complaints of the patient as a disgruntled malcontent. I would argue that this represents a potential opportunity for improving processes.
- Stick to the facts Try to not disparage the patient as that only invites an online flaming contest. Don’t argue And be carefully not to violate, or even come close to violating the patients privacy rights. The bottom line is that you as a physician are held to an infinitely higher standard of privacy than your patient is.
- Almost every review can be responded to in a creative and disarming way.
- What probably works best in addition to a sensible response to the review and reaching out to the patient is to flood the site with positive reviews. Encourage satisfied patients to leave positive reviews. The ones most likely to be able to leave you a review are actually the ones who found you on line so target those reviewers. In our intake paperwork, we have a section for patients to tell us how they found us, for example physician referral, insurance website, or online for example. This allows us both to track the effectiveness of our reputation management as well as to target “yelpers” for soliciting new reviews. We also have an internal review process which allows us to flag particularly positive reviews and encourage them to post online.
- Just a quick on filtered reviews. Some sites have an algorithm for hiding reviews. Nobody understands the rhyme or reason, but one reason a review can be filtered or hidden is multiple reviews from the same IP address.
- I’m going to pivot for a moment and discuss the broader downsides of physicians reviews, whether they be online or as a formal part of healthcare evaluation. Here is a study from the Annals of medicine
- So this was an essay written by a thoughtful physician last year when he was president of the pennsylvania association of family practice again highlighting the real life dilemmas faced by physicians trying balance good medicine and public policy with patient satisfaction. You can see some of the examples here with overprescribing of antibiotics and narcotics.
- One of the important points in putting together a presentation is to know your audience and while todays audience tends to skew a bit towards private practice, where this is quite relevent, I am sure there are some employed or academic physicians out there who feel this doesn’t apply to you. Well this next section is for you.
- And it just goes to prove that all wisdom is derived from Rolling stones lyrics one way or another.