When Samuel Foster, MD, and his wife Roshni Foster, MD, bought a Denton-area allergy and asthma practice in 2015, they found out quickly that the practice didn’t make a very good first impression for anyone looking it up online.
“One of our [three] offices was listed on Google Maps as permanently closed,” Dr. Samuel Foster said. “That’s a case where you’re potentially losing business — losing patients — who are searching for you on the most important search engine out there.”
The new owners of North Texas Allergy and Asthma Center found other online problems, and the next few months became a crash course in reputation management.
For medical practices, that is a twofold process, says Brad Davis, a practice management consultant at the Texas Medical Association. The first part touches on how your practice is viewed in search results. Is the information correct? Does it put your practice in a favorable light?
The second part involves the numerous ways patients can review physicians online through websites like Yelp, Facebook, Google My Business, and Healthgrades. Physicians cannot always change the negative content or even reply to it in some cases. But they can correct and add content, and they can make sure that happy patients are submitting comments, too.
Mr. Davis recommends physicians ask themselves: “Are you utilizing everything that’s free out there, to not only have your presence out there but also be alerted when someone reviews you on one of those rating sites?”
For many independent practices, the answer to that question is no, Mr. Davis says, for many reasons. Most physicians are not trained in either communications or digital technology, and so have little understanding of the financial impact of search engines, social media, and review sites. Also, keeping track of these tools is just one more burden on office staff. Even so, it’s a burden physicians can’t afford to ignore, says Mr. Davis, who assists members through TMA’s reputation management consulting service. (See “TMA and Officite Can Help Your Online Presence,” page 43.)
“I get a lot of doctors who say, ‘I don’t even have a Facebook page,’” he said. “And I say, ‘You don’t have to — for you. But your practice needs one.’ I equate it with a sign. You wouldn’t not have a sign above your door. Not having a Facebook page is almost the equivalent today.”
Step one: awareness
The first step to improving a practice’s online reputation is understanding how your reputation can affect your bottom line. Abundant research shows that patients often look to online reviews of physicians before making an appointment. (See “Do Online Reviews Matter? Yes!” page 42.)
Dr. Foster and his wife had a clear understanding of the importance of their online reputation, and they spent time improving it. They set out first to correct errors, like the problem with Google Maps.
“It’s just getting online and searching for yourself and searching for your business, and then painstakingly going through each site and looking to make sure that addresses, phone numbers, office hours are correct,” he said.
Some review sites — like Vitals or Healthgrades — generate data automatically for anyone with a national provider identifier, but this information can be badly outdated, Mr. Davis says.
“The information [these sites] pull is just whatever they can find,” he said. “It could be from the last practice you were at. It could be from a practice you were at four years ago. The information is not always necessarily correct.”
To prevent this, physicians can “claim,” or get editing privileges for, the review sites that mention their practice. For instance, Dr. Foster’s staff contacted sites like Yelp and Google Plus to let them know who owned the practice. In most cases, the review site then sent a postcard to confirm ownership. Once that was done, Dr. Foster was given access to control some of the content on the review site.
“In some cases, before we took possession of and updated the information on Yelp and Healthgrades, there were patients who reviewed doctors who were never part of our practice,” he said. “And there were patients who posted information that could be potentially discriminatory or offensive. And obviously if you contact the platforms, that information can be removed.”
Claiming a review site does not allow the physician to alter negative reviews, even if those reviews seem unfair or misleading. Physicians can respond to those reviews, but that is seldom a good idea, says Mr. Davis. First, it can create an unpleasant back-and-forth with the aggrieved patient that could turn off future patients.
More importantly, it can cause physicians to run afoul of HIPAA regulations. Even acknowledging someone as a patient can violate HIPAA, and discussing specifics of care can lead to further complaints and even lawsuits. In 2016, news website ProPublica identified more than 3,500 low ratings for medical care on rating sites. It found that dozens of those reviews turned into disputes between doctors and patients over patient privacy.
The best approach is to either ignore a negative review or give a noncommittal answer, Mr. Davis says.
“You should have very little if any interaction with a patient online [over a negative review],” he said. “And if you respond, make it generic like, ‘Thanks for your review. Please contact our manager at X.’ Just nothing that identifies them as a patient.”
However, physicians do have ways to counter negative reviews. One of the best is to surround them with positive reviews. Physicians can do this by encouraging all patients to write comments after their visits. Without that nudge, many people who are favorably inclined may not act, Dr. Foster says. Also, staff members may need to guide patients to the review site they are most comfortable with.
“My experience is that this is somewhat generational,” Dr. Foster said. “Some populations are more likely to post reviews on Facebook. Others get more information on Twitter or Google. I think it’s just a matter of making sure your office staff is able to direct people appropriately and can give people multiple options.”
Since most negative reviews stem from at least a nugget of reality, TMA also recommends that physicians use them as practice improvement opportunities.
Deciding what’s important
In many ways, North Texas Allergy and Asthma Center had a leg up on other independent physician practices. Dr. Foster and his colleagues already had begun to clean up problems on some review sites. But there are dozens of these sites, and they were not sure which ones were most important. (See “Top Physician Rating Sites,” page 41.)
“There really are too many of them to monitor,” Dr. Foster said.
So Dr. Foster turned to TMA Practice Consulting to guide him — and to get an independent evaluation of the practice’s online presence. The 27-page TMA report he received examined four main areas:
• Optimizing the current practice website: While the practice’s website did most things right, it needed improvement in areas like letting patients make appointments and including reviews or testimonials from patients.
Evaluating ratings on popular physician review websites: The practice had a strong presence on some review sites like Yelp, but had not claimed other important sites, like Vitals. On Yelp, the report recommended minimizing confusion by removing information about specific doctors in the practice and instead giving general information about the practice locations.
• Use of social media: The practice had an excellent presence on social media, especially Facebook.
• Rank on search engines: Every practice wants to improve search engine optimization. Ideally, that means its name will pop up first whenever someone Googles the practice’s name or any related words — in this case words and phrases like “allergy,” “asthma,” or “food allergy.” The report showed where the practice ranked in keyword searches by local residents, and suggested keywords for the practice to include on its website and social media sites. The use of these keywords has been shown to boost rankings on search engines.
North Texas Allergy and Asthma Center divides the duties of updating its website and policing the internet among several staff members. But not all practices have the staff or expertise to take on those chores.
C. Turner Lewis, MD, a Kaufman pediatrician, opted to go with a TMA-endorsed service provided by Officite to revamp his website as well as find and implement ways to improve his practice’s online presence. The vendor that had hosted Dr. Lewis’ website had cumbersome procedures for updating the site that required going through several subcontractors. Also, the practice had done little to address problems on review websites or to improve search engine optimization.
Dr. Lewis says Officite revamped the practice’s website, incorporating changes that his staff wanted to see. Since then, it’s been much easier to update the website and add a blog, which increases search engine optimization by making it easy for him to put out regular articles about the practice. The practice also now has Officite policing review sites to look for problems.
“We became much more aware of not just our online reputation, but who was commenting or not commenting,” he said.
Overall, Dr. Lewis has had a positive experience. Ratings sites typically rank physician practices on a five-star scale, with five stars being the top rating. After engaging Officite in 2017, the practice’s average ranking on Facebook rose from 4.1 to 4.7. That has translated directly into increased business, Dr. Lewis says.
“Our new patients per month has more than doubled,” he said. “[It] was at 40 and now we’re up to 90.”
Dr. Foster says he was similarly pleased with the help he got from TMA Practice Consulting.
“Prior to engaging with TMA, we had talked with other companies that provided online reputation recommendations to business of all types,” he said. “I felt that they didn’t have as much understanding of the medical space and how management of your online reputation differed from nonmedical businesses.”
Websites are always changing, and keeping up with those changes is a chore, but it can also pay off if done right, Dr. Foster says.
“If you don’t maintain [your online reputation], someone else will,” he said. “And they may not have your best interests at heart.”
TMA Can Help
The Texas Medical Association’s Education Center features several continuing medical education courses to help you improve your online presence, including:
Thanks to TMA Insurance Trust, hundreds of hours of CME in the TMA Education Center are now FREE for TMA members and their practice staff.
Tex Med. 2019;115(4):39-43
April 2019 Texas Medicine Contents
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