Dealing with online ratings often proves challenging for doctors

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-of-mouth 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 co-authored 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 perspective, 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.

Follow Sabriya Rice on Twitter: @MHsrice