© 13_PHUNKOD / SHUTTERSTOCK.COM
A practice with seven physicians was having financial issues—two of the physicians were in the top quartile financially, but the other five were performing below the average. Those five had an amount of uncollected revenue for their accounts that was $1.2 million more than the two doctors in the top quartile, a big number for a group this size.
These accounts receivable affected the whole practice because of the shared overhead costs that were used to generate this uncollected revenue, said James Benson, MS, president and founder of QM2 Solutions, a medical consulting firm hired to help the practice. He discussed the case in a session at the 2021 American Academy of Otolaryngology–Head and Neck Surgery Annual Meeting.
What was going on? Mr. Benson said his firm looked at the practice’s online reputation and found that its Google scores were less than four out of five stars, a score that many potential patients would find unacceptable. That translated into a bottom-line hit, he said. Every new patient would bring a lifetime value of $900, and, “based on their market environment, they were losing about 15% of their potential patients as a result of their low ratings,” Mr. Benson said. “This practice was being strangled by a poor reputation.”
Experts in the session said there was no getting around it: Physicians must cultivate a winning online reputation to be successful. They said creating a great experience for the patient is the bedrock of that reputation, but promotion and regular attention is critical too. Online ratings are often seen as more important than where a physician went to medical school or did their residency, and many patients are willing to venture out of their insurance network to go to a doctor with more favorable reviews.
Improving an online reputation involves asking patients and stakeholders what they’re really thinking, refining what needs work, and leveraging what you do well so that people know about it.
“The bottom line is that poor patient experience decreases your payments and increases your risk, while great patient experience improves your revenue and decreases the likelihood that you’re going to be sued,” Mr. Benson said. “It’s that simple.”
Branding Your Practice
Angela Sturm, MD, a facial plastic surgeon in the Houston area, puts her brand and her patient stories just about everywhere, including YouTube, Facebook, TikTok, and Instagram. She thought carefully about the image she wanted for her practice: modern, welcoming, and patient-centered.
“I put my brand everywhere—from the front desk when you walk in, to the cup we give them at preop, to my business cards, to the intake forms. Everything we do, we want our patients to have the feeling of being cared for,” she said.
Even if social media isn’t necessarily your thing, and it isn’t for everyone, you still need to
have a presence. You do have to show that you’re active in the community and on top of what’s going on in the world. —Angela Sturm, MD
Physicians who want to do branding right should create a consistent patient experience with a similar look and feel through every interaction, from the website to social media to the business cards and staff uniforms.
Reviews are essentially online word of mouth, said Dr. Sturm, and happy patients should be encouraged to review. Negative reviews will be unavoidable but, when things are done right, they will be overwhelmed by the positive reviews.
Dr. Sturm encouraged those who might be reluctant about having an online presence to do it anyway. “Even if social media isn’t necessarily your thing, and it isn’t for everyone, you still need to have a presence,” she said. “You do have to show that you’re active in the community and on top of what’s going on in the world.”
Handling Negative Reviews
Eventually, bad reviews will appear online. How a physician handles them can determine whether his or her reputation will take a real hit.
Aaron Minc, Esq, a Cleveland-based lawyer who specializes in protecting online reputations, said the first step should be to call the patient promptly.
“Listen, don’t talk. Don’t get defensive, don’t use insults, and don’t make excuses. Don’t take things personally, and be prepared to apologize and provide an appropriate remedy. Speed is key; reaching out within 24 hours of the negative posting is critical. Avoid putting things in writing—it’s less personal and can lead to things being misconstrued, making a bad situation even worse.”
Because of ethics rules and HIPAA, physicians are extremely limited in what they’re allowed to say online; even saying a patient’s name confirms that they’re a patient and is problematic. “I get it; it isn’t fair,” said Minc. “But just because a patient talks about their treatments online, it doesn’t provide permission for a physician to be able to respond publicly. Given how restrictive regulations are, my advice is that physicians shouldn’t publicly respond to online reviews at all.”
Physicians can try to get a review removed , said Minc, but this can be difficult and depends on the review’s language and the site’s terms of service. These sites should never be threatened legally—they’re generally immune from liability stemming from the reviews.
If a review is serious in nature, such as allegations of malpractice, harassment, or racism, then more aggressive legal action is likely necessary, Minc said. “Consumers don’t expect perfect online ratings. But sitting back and doing nothing about your online reputation isn’t an option.”
Thomas R. Collins is a freelance medical writer based in Florida.