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Do Online Ratings Matter?

Do Online Ratings Matter?

Larry Schlesinger doesn’t much care for online rating services that let patients bash their physicians under the veil of an anonymous post. So he’s taken matters into his own hands.

Starting in 2007, the plastic surgeon in Maui, Hawaii, who has practiced medicine for 28 years, began asking his new and existing patients to sign a legal contract that precludes them from posting online ratings (either rants or raves) about the treatment they receive at his office. Any statements they do post about his services become his property under copyright law.

To date, says Schlesinger, 100 percent of the nearly 12,000 patients he has asked to sign the contract, which was created by malpractice defense firm Medical Justice in Greensboro, N.C., have done so without hesitation. Why? In return for their discretion, he grants each patient additional privacy protection beyond that mandated by HIPAA or state confidentiality laws.

“Physicians in all specialties are very honorable, hard-working people and we live or die on our reputations,” he says. “If someone assaults your reputation — internationally — by spewing venom on the Internet that’s unhealthy for the person putting it up and for the doctor and it’s a really mean thing to do. Patients who demand their right to do so should probably not be your patients.”

Patient contracts are but one of the many responses by the medical community to the proliferation of Web-based rating services. Feeling suddenly vulnerable to consumer review, physicians across the country are grappling with how best to respond— whether it makes more sense to maintain a low professional profile or harness the power of the Internet to their advantage.

New to consumer review

More than 30 such doctor rating sites exist today, including pioneers RateMDs.com and Healthgrades.com, and their ranks continue to swell. In 2008, for example, national health plan Anthem and the nation’s largest health benefits company, WellPoint, both partnered with restaurant- and hotel-rating guide Zagat to let consumers share their physician experiences with others online. Angieslist.com and Yelp.com are also gaining ground in the MD rating space.

Advocates, of course, say rating sites are a plus for healthcare consumers who previously had few tools with which to compare physicians on everything from communication skills to waiting room cleanliness — and even fewer opportunities to evaluate their doctors using patient-to-patient review. It’s a high-tech, modern day equivalent of chatting with your neighbor over the backyard fence.

Many physicians, however, contend that consumer review Web sites perform a disservice to patients because their sample sizes (of respondents versus the patient population) are statistically insignificant and they may actually encourage patients to pick physicians based on factors less significant than quality of care.

“We think these Web sites are a little ahead of their time,” says Jeffrey Segal, a neurosurgeon and chief executive officer of Medical Justice. “If you’re trying to pick a surgeon most people would choose to see a highly competent jerk versus someone less qualified with wonderful bedside manners. The bottom line is that we’re not going to marry our doctors. Not all things are equal.”

Another criticism of MD rating sites is that many allow registered users to post anonymously, giving not just unhappy patients a forum to sully your reputation but disgruntled former employees, embittered ex-spouses, and unscrupulous competitors as well.

Online rating services, of course, aren’t exclusive to physicians. Most service providers and product manufacturers have been subject to consumer reviews for decades. But Stewart Gandolf, founding partner of HealthcareSuccess.com in Irvine, Calif., says the trend has been a harder pill to swallow for doctors who have had little exposure to the “dirty world of business marketing.”

“No one in corporate American likes ratings sites, but healthcare is really the deer in headlights because they’ve been so isolated,” says Gandolf, noting that marketing of professional health services was illegal until 1977. “There are a lot of doctors who are very uncomfortable with this thing they can’t control and think, ‘You’ve got to be kidding me. I had enough to worry about before.’”

The only thing we have to fear…

Yet, Steve Feldman, a practicing dermatologist, professor of dermatology, pathology, and public health sciences at Wake Forest University in Winston-Salem, N.C., and founder of physician rating site Drscore.com, says his colleagues have nothing to fear. “These Web sites are actually one of the best things ever to happen to American medicine,” he says. “Think of it this way. When you give the right diagnosis [which happens the majority of the time] no one ever hears about it, but God forbid if one of your patients has an unfavorable outcome or is harmed in some way — you can believe that’s front page news.”

Web sites such as his, he says, give satisfied patients an opportunity to sing your praises. Indeed, the median score of a doctor with 20 or more ratings on his Web site is 9.3 out of 10. “Patients love their doctors,” says Feldman. “It’s amazing how good doctors are in the United States and no one knows it.”

How to raise your score

If you find your name in lights on an online rating site, and eventually you will, don’t despair. The important thing to remember is that your score isn’t set in stone. There are ways to bring up your rating and at least a strategy or two to combat negative posts as well.

Gandolf says the best way to boost your score is to encourage your patients to counter negative posts with positive ones. “The genie is out of the bottle,” he says. “You can’t control it. The only thing you can do is to have legitimate patients put up posts on their own.”

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