In a recent post, Should Healthcare Professionals Sue to Protect Their Online Reputations?, we discussed several cases where physicians have sued over posts made in an online forum.  Legal challenges to negative reviews have had mixed results.  Remember David McKee, M.D. – one of the doctors we discussed in our last post who sued a patient’s son over his online posts.  The negative online reviews were posted in the spring of 2010, but the Minnesota Supreme Court did not rule until January 2013 that the statements were not defamatory, and thus, his claims had been properly dismissed.

So – what other options are there?  Some suggest that health care professionals should embrace online reviews.  The Center for Quality of Care Research in 2010 conducted a survey of 33 physician-rating websites which rated 81 physicians.  Of the 190 reviews surveyed, 88% were positive, 6% negative and 6% were neutral.  Similarly, Tom Seery of Realself.com, an online review and comment board for cosmetic treatments, found that 90% of the patient reviews on Realself.com were positive, with a small mix of negative reviews and a smaller number of mixed reviews.  Dr. Steve Feldman, a practicing dermatologist, professor of dermatology, pathology and public health sciences at Wake Forest University, and founder of a doctor rating site, Drscore.com, could not agree more.  Dr. Feldman told Physicianspractice.com, Do Online Ratings Matter?, “[t]hese Web sites are actually one of the best things ever to happen to American Medicine.”  Dr. Feldman believes medical rating sites give satisfied patients an avenue to describe in positive terms the care and treatment they received.  Indeed, the median score of a doctor with 20 or more reviews on Drscore.com is 9.3 out of 10.  “Patients love their doctors,” says Dr. Feldman.  “It’s amazing how good doctors are in the United States and no one knows it.”

I would agree with Dr. Feldman that social media provides patients the ability to praise their doctors, and that the praise might help boost their physician’s practice.  But what about the nearly 10 % of negative reviews – can and should a doctor respond in an online forum?  Physicians should first look at the content of many of those negative reviews.  According to doctoredreveiws.com, How to Respond, the most common patient complaints relate to the physician’s business practices, such as parking, wait times and staff attitude.  This is information that many practices would welcome and take steps to correct!  This kind of review may also provide the practice the opportunity to respond and let the reading public know that the practice will listen to patient complaints and take affirmative action to improve the quality of the patient’s experience.

That said, it is usually the online posts about direct patient care that causes concern among health care providers.  Yet, in those instances where the negative criticism relates directly to patient care, and thus, implicates a patient’s privacy, the health care professional must step back to determine whether an online response is necessary and appropriate, or perhaps whether reaching out to the patient is the best bet.  While the online site may require the reviewer to waive privacy constraints prior to posting the review, this might not insulate the physician.  We recommend contacting legal counsel to insure that such a responsive post would not violate either state or federal patient privacy laws.  If a negative review persists, the clinic or doctor might try contacting the patient directly  -  asking about how the concern can be remedied and ultimately whether the patient will take the negative review down.  A final option might be to contact the review site.  The review site might refuse to take the post down, but if the information is clearly false, inflammatory or appears to be for the purpose of harassment, the review site might respond to a plea to remove the post (although they don’t have to do so).

So can a health care professional take charge of his/her online presence?  Dr. Kevin Pho, a New Hampshire internist and writer of a physician-focused blog on health and social media called KevinMD.com, believes legal action is the wrong approach in curbing negative online reviews.  “In general, I can’t think of a time where a lawsuit would be tremendously effective.  The negative publicity and the fallout from the lawsuit is far worse than the initial issue,” Dr. Pho reported to American Medical News, Doctors’ legal remedies can defeat online attacks.  “It’s a better idea to take charge of your online presence.”

For instance, Dr. Pho believes physicians should join social networking sites, such as Facebook, LinkedIn, and also participate in community health boards, blogs and chat rooms.  According to Dr. Pho, a physician’s online efforts will show-up first during a Google search of his/her name, thereby pushing any negative reviews down the list.  This is certainly how many industries increase social media presence, so it seems reasonable for health care professionals to do so as well.  Although I would add a caution that health care professionals should exercise extreme care when interacting with patients in an online setting (think patient privacy).

So what is the right answer?  In the end the best bet may be to do nothing – at least as it relates to online criticism.  As I advise clients in other industries – get a thick skin and don’t respond to criticism unless really necessary.  If a response is appropriate, consider reaching out to the patient directly.  Perhaps this is a little old-fashioned, but direct communication can resolve disputes better than online barbs.  Finally, if you are a health care professional, take an active role in your online reputation to increase the number of positive “hits” the public might find about you or your practice.  If any of you have other ideas for health care professionals, please contribute your thoughts.