By Jeff Rydburg, MGMA member July 1, 2015
Published in MGMA Connection Plus, July 2015 Issue

Online reviews and rating sites are the new word-of-mouth.

How do you increase exposure and get your practice name in front of prospective patients? Some have used billboard advertising (traditional and Internet) to accomplish this feat. Yet what some industry members fail to recognize is that prospective patients are searching for doctors online and look for reviews and other information online before scheduling appointments.

HCA Physician Services, Brentwood, Tenn., started a reputation management initiative several years ago and was able to improve ratings and reviews published by third-party sites, which had an 18% increase on new patient growth.

Today personal recommendations and word-of-mouth referrals are frequently cited as the best forms of advertising, yet it can take months for referrals to spread among friends. Positive and negative reviews can reach thousands of people instantly through social media channels, and patients are increasingly using online review sites, according to an article published in the Journal of the American Medical Association (JAMA).

One study showed that 88% of consumers trust online reviews as much as personal recommendations, according to a BrightLocal Consumer Review survey from July 2014. Another study found that 62% of patients who read online reviews go to physician rating sites as the first step when seeking new doctors. Study results were updated in 2014 and showed that the number of patients who use online review sites increased from 25% in 2013 to 42% in 2014. Additionally, 44% of patients were willing to go out of network based on more favorable reviews compared with 26% in 2013. Judging from this data, online reviews and rating sites are the new word-of-mouth.

Everyone probably uses some form of ratings information when researching other businesses. Now patients are using these ratings to determine what physician they want to see. Among the patients who used physician rating sites, 35% selected a physician based on good ratings and 37% avoided physicians with bad ratings, according to the study results published in JAMA.

If you did an online search and half the reviews for a practice were negative, would you go there? In most markets, searching for “best family practice doctor” in a city produces rating sites — Yelp, Healthgrades, Google My Business, RateMDs and Vitals, to name a few — not practice names. Therefore, patients will often see information from these sites before they find your website.

It is important to know what patients are saying on these sites. Most include a star rating system and verbatim patient comments. Nearly all rating sites are free to patients and easy to use.

Smart business
Considering that 37% of prospective patients avoided doctors with bad reviews, it is important to manage your online reputation to maintain and grow a healthy practice. One study, published in Harvard Business Review, shows that the increase of half a star rating on a five-star scale could increase revenue as much as 5% to 9%.

Managing your online reputation includes three steps:

  • Claim your profiles.
  • Monitor online activity.
  • Manage your reputation.

The first step is to ensure that information on the Internet is current and accurate. Claiming and updating all of your profiles can be time-consuming as every search site creates its own profile for a physician or practice. However, this information (i.e., address, phone number, physicians, etc.) must be current, and you must be identified as the business owner and the only person who can change information. We have found inaccurate information posted online several times. For example, one of our practice listings had a competitor’s phone number. In another case, our physician was listed as deceased.

Monitoring rating sites
Some practices have sophisticated patient satisfaction surveys and don’t think they need to monitor online activity. Unfortunately, patient satisfaction surveys are only one feedback channel, and since patients typically can’t see your internal patient satisfaction results, it does not affect your online reputation. We post our patient satisfaction results on our websites as an average star rating for physicians, but online rating sites won’t allow your internal ratings to be posted on their sites. Adding a star rating on your site might prevent a patient from looking for other rating sites.

In many cases, if your physician reads something online that is unflattering, he or she might want to fire off a response or get an attorney to make the patient rescind the comments. Unfortunately, that is the worst action to take, and courts have not helped physicians in this regard. First, HIPAA and privacy laws prevent you from discussing a patient’s care online, and “the patient started it” is not an acceptable defense. Second, the physician usually comes across as petty, which escalates the issue. When handling a negative review, view it as an opportunity for service recovery. If one patient had a bad experience, it is likely that others did. Once you have identified and solved the problem, you should not get any more negative reviews on that issue. Then you can post a “thank you for bringing this to our attention” response.

We implemented our reputation management initiative a couple of years ago because we thought patients were using new online search tools and feared our traditional marketing methods were outdated. Interns at our practice reviewed the most popular rating sites, tabulated the number of reviews and tallied the responses — positive or negative. The majority of our practices had a small number of reviews, but in some cases, half of them were negative. I believed this was scaring off new patients so we started cleaning this up. In some cases, rating sites allow physicians to hide a couple of negative reviews, which can make a difference in patient perception. However, you often can’t hide or eliminate all negative reviews.

The best way to combat negative reviews is to address the issue and then try to increase the number of positive reviews. However, I don’t believe you should write (or ask staff to write) fake, positive reviews because I think (and attorneys concur) that this is unethical. Many rating sites monitor IP addresses for reviews and will issue penalties for misuse. Instead improve your practice’s online reputation by providing patients with links for various rating sites and asking them to write reviews without any incentive.

Reviews and comments appear in chronological order so if you acquire 10 positive reviews, negative reviews will be bumped to page two of the search results. A couple of negative reviews might not negatively affect a patient’s choice if the overwhelming majority of comments are positive.

To manage this process, we hired a full-time person who worked closely with practices. We started with the practices with the highest percentage of negative reviews and reduced the percentage of negative reviews from nearly half to less than 20% for some sites. After practices improved their online reputation so that more than 90% of the reviews were positive, we saw an 18% increase in their new patient growth.

Some practice professionals hope this trend of online reputation management will go away, and many physicians don’t trust what patients post and believe others don’t read it. However, studies show that patients trust this information and in this age of transparency, we should actively engage this medium. Manage your practice’s online reputation and turn loyal patients into advocates for your practice.