Doctors have an online presence, even if they don't know it yet

Physicians who sue perceived online detractors may often hurt only themselves. While trying to protect themselves from negative reviews posted on websites, they can instead cement their bad reputations by publicizing allegations within the lawsuit.

A better option may be to counter negative reviews with a positive online presence. That requires doctors to enter into social media endeavors that they may feel inadequately prepared for or don't have time to address. But blogs and social media outlets are more likely to show up in a Google search than the entries on a physician review site, said Kevin Pho, MD, ACP Member.

Dr. Pho has rapidly become an acknowledged expert in all of the ways health care intersects with social media. His blog, KevinMD.com, aggregates many physician bloggers, and he's spent years building his own online presence.

According to Dr. Pho, 44% of patients are going online to research their doctors, and 20% are using physician rating sites to do so. It's up to doctors to be in control of how they appear online, and he explains how in a new book, “Establishing, Maintaining and Protecting Your Online Reputation: A Social Media Guide for Physicians and Medical Practices.”

Q: What are the first steps that physicians need to take when monitoring their online presence?

A: A lot of doctors don't know that they already have an online presence. If you Google a typical doctor's name, the search results will include something from third-party rating sites such as Healthgrades or Vitals. These profiles may contain inaccurate information: wrong address, wrong phone number or wrong board certification. Even worse, it could contain physician reviews that could be negative. So whether doctors like it or not, they already have an online presence. It's up to us whether we want to control it or whether we let others dictate how we appear on the Web.

Q: How should doctors counter a negative presence online?

A: Doctors can claim [their] page and correct [erroneous] information on the vast majority of rating sites. Sometimes this requires a fee. Where physicians are frustrated is when a patient writes a negative review on these profiles and they cannot respond.

The biggest fear that these doctors have is how the negative reviews affect their online reputation. They always ask me, “How do you get these sites shut down? How do you get these comments removed?” The answer is that, in many cases, they can't. I'm aware of very few successful lawsuits where a doctor has successfully brought one of these sites to court to remove a negative review.

Besides, if you look at other industries like books, movies and hotels, people have shown they want to read reviews online. It's the same for doctors. Online ratings bring a transparency that will not go away anytime soon.

Q: What can they do instead?

A: There are a few simple things that you can do. Number one is to read them. Some of these reviews don't necessarily have anything to do with clinical care. The front office staff may be rude. There's not enough parking. The magazines aren't up to date. Sometimes patients are frustrated that they never hear from their doctors after they go in for a lab test. Patients even write that doctors are too busy looking at their laptops or their electronic medical records rather than the patient. These are all correctable things.

The second thing that doctors have to realize is that the majority of these reviews are positive. Various studies that show that up to 90% of online physician ratings and reviews are positive and are better than a lot of doctors realize.

One way [for doctors] to leverage this finding is to ask more patients to rate them online. Doctors shouldn't just cherry-pick the patients, but ask all of them. Give them cards with directions to a review site of choice and instructions to enter a review. Earlier this year, there was a study in the Journal of Urology that found that most doctors averaged about 2 ratings on these sites. That's too few to be useful. If you ask more patients to rate you online, the majority of them are going to be better than most doctors will think. Negative reviews will look more like outliers.

Q: Where would doctors start when establishing an online presence?

A: My No. 1 step would be to get comfortable with your online presence. One of the best ways of doing so is spending 30 minutes to create [a profile] on LinkedIn, a social network that's associated with professionals. Physicians can highlight their professional experience and where they work. They can highlight their educational background. And these are all things that are relevant to what patients want to know about the doctors.

The beauty of a LinkedIn profile is that there have been studies where they've compared LinkedIn with other social media networks like Facebook, Twitter and Google+. It's actually LinkedIn that shows up highest when a name is Googled.

A second option would be a Google+ profile. It's very similar. You put a few paragraphs about what you do and where you practice, and put it up on Google. The advantage is Google is going to look at its own social network more preferentially [in a search].

Q: What comes next as internists start to establish a positive online presence?

A: Next, I would move on to something like Twitter. You can go to Twitter and set up an account, but you don't have to contribute information. Use Twitter to listen. You can follow other doctors or other health professionals that have the same interests as you. Click through to the articles that they share.

We are in the age of information overload. There are too many journals. There are too many studies. There are too many articles. There are too many discussions to take part in. If you follow a defined group on Twitter that has similar interests, you can use that as a curation mechanism.

If physicians get comfortable with that, they can take the next step, which would be contributing information. They can share their own stories on Twitter. They can offer their own opinion on what they think the latest guidelines are. They can dispel any myths that are being reported by mainstream media.

Q: How should doctors progress from listening and curation to contribution?

A: If physicians have a voice that they want to share, then I would go ahead and start a blog. It requires more effort to start and maintain, but it has tremendous benefits.

The more social media platforms that you engage in, LinkedIn, Twitter or a blog, the bigger your digital footprint will be. That's going to expand your presence online so when patients Google you, not only are they going to find your LinkedIn presence, they're going to find your Twitter presence. They're going to find your blog. The best thing is you're in total control of how you appear online to patients.

Blogging, however, requires a certain amount of commitment. You can't expect to start a blog and instantly obtain a readership. It takes a while before you can get a loyal following. The more you post, and the more regularly you post, the easier it's going to be. I would recommend at minimum once a week.

You need to define what the goals are of your blogging. Do you want to educate patients? Do you want to talk to other doctors? Do you want to talk about politics? Do you want to talk about health care reform? You have to determine what your voice is before you start a blog and think about what your goals are.

If a blog is too daunting, there are other ways to contribute your voice online, including a Facebook page, or on Twitter.

Q: What's the ultimate goal of this amount of work?

A: The goal is to be in control of the information about you when patients Google you. Creating an online presence through blogs or social media profiles is a powerful way to establish and protect an online reputation.

Doctors may be apprehensive of being so visible on the Web. But they don't have a choice. If physicians don't take the steps to proactively define themselves online, others will do it for them whether they like it or not.

An online reputation will soon be as important as a reputation within the community.