How to use online patient comments to your advantage

When patients go online to discuss their physicians, they are more likely to sing their doctors' praises than criticize them, according to a recent study. And if they do criticize, it's usually about the parking lot, the waiting room or the carpet -- anything but the quality of care.

So experts say that when physicians think about how they want to deal with unflattering, unedited, unfiltered online comments, they should consider more than just what punitive action they can take if something bad is said about them. They should look at how both to encourage more patients to visit the sites and to control the information available.

Tara Lagu, MD, MPH, a Tufts University School of Medicine assistant professor based at Baystate Medical Center in Springfield, Mass., said the perception that people offer feedback only when they have something negative to say doesn't hold true when it comes to medicine.

Dr. Lagu and colleagues examined online reviews of 300 physicians on 33 different physician rating sites and found that nearly 90% of the reviews were positive. The negative comments were mostly actionable criticisms that physicians could address immediately without compromising patient confidentiality. The sites examined were public sites where patients leave reviews and did not include those sponsored by insurers. The research was published May 13 in the online Journal of General Internal Medicine.

Despite the overwhelming positivity of the reviews, however, the sites are a source of concern for many physicians. They worry that disgruntled patients -- or even imposters -- could go on the sites and try to ruin doctors' reputations.

Experts say responding to the negative message isn't usually the best strategy. A physician's time is better spent drumming up positive reviews.

"Jumping to a lawsuit is definitely the wrong direction," said Anthony LaFauce, director of digital strategy for Spectrum Science, a Washington, D.C.-based health and science public relations firm. "What you can do is create counter-messaging to promote the good you are doing to help get on top of that negative messaging. Because if you go out and attack this person through a lawsuit or through a counter-post on that same website, you're validating their claims."

LaFauce said directing good comments back to the same site will help drown out the negative comments. And if the majority of the reviews are good (which they generally are, he said), the bad comments are more likely to be hidden and won't be too damaging.

Dr. Lagu said that although most sites do not give physicians an opportunity to respond to reviews, she thinks it would be a useful feature. She said physicians could give updates when problems are addressed, much like hotel operators do on hotel review sites.

Amanda Vega, a Phoenix-based social media consultant, said the best place to respond to criticisms might be on other web pages that are facilitated by the practice itself. Creating Facebook or Twitter accounts allows practices to control the message sent and viewed by potential patients. Social networking sites such as these are more likely to show up on a search than physician rating sites, none of which are household names, Vega said.

Vega said the sites can be used to acknowledge complaints about a particular problem, such as wait times, and the practice can tell patients what they plan to do about the problem. But knowing what people are saying is the first step.

Practices can set up online alerts that send links to any blogs or websites where that practice or a physician's name is mentioned. Google has an easy-to-use alert system, called Google alerts, that will send an e-mail each day with all links that contain predetermined keywords or phrases. LaFauche said many people are more likely to post in smaller niche forums than large sites. Constant monitoring through an alert will help identify those sites.

Even though you may choose not to respond to the feedback or comments made, practices should maintain a presence on social media sites anyway. The more active a practice is on a site like Twitter, the more likely it will jump to the top of any search someone might do on the practice's name. Practices can use the sites to solicit positive feedback as well.

But despite a practice's effort to keep it positive, Vega said, sometimes egregious things are written. And in cases when information is clearly false, something should be done.

The issue usually can be resolved by contacting the site administrator, said Vega, who has successfully worked with site operators to have things removed about her clients that obviously were written by someone who was never a patient or whose sole intention was to spread false information. It's much easier to plead your case when the majority of comments about you are positive and are in direct contradiction to the negative review in question.

Few situations would warrant action like that, LaFauche said. Most negative comments can be diluted through positive ones.

"Cultivating positive responses is worth its weight in gold versus trying to fight a negative response," he said. Physicians should not be ashamed to direct patients to their Facebook pages or some other trusted website, where comments can be made.

Dr. Lagu agrees that the sites are something physicians should embrace rather than fear.

"It doesn't make a lot of sense ... to resist as we have been resisting," Dr. Lagu said, adding that sites will continue to develop "with us or in spite of us." She advises working with sites directly or "encouraging our patients to work with them to really get them to serve our patients and us better."