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Up Front | Sep 2008

Participation Required

How and why to act now to protect your online reputation.

I am concerned that the pervasiveness of opinions about medical practitioners through rating services, blogs, and other online forums will send ophthalmologists deeper into the foxhole. When working with elective vision surgery practices, I often see doctors attempt to use the informed consent document as a battering ram to head off patients' retaliation. Medical Justice (Greensboro, NC), a company founded by neurosurgeon Jeff Segal, MD, offers a ratings-permission contract to physician subscribers for their patients to sign. It requires them to ask for permission before grading the doctor online. Dr. Segal states, "The whole notion of your reputation on the line and not having control makes physicians feel vulnerable. The goal is to regain control of the information flow."1 Physicians simply cannot regulate, legislate, or dictate a patient's behavior and satisfaction. Furthermore, doctors certainly cannot silence patients' commentary, regardless of signatures they attempt to secure. Physicians can participate, however, so that provider/patient relationships are enhanced.

The American Medical Association and Medical Society of New York have endorsed the efforts of New York State Attorney General Andrew Cuomo to make sure rating sites proposed by insurers rank both the quality and cost of care. In this manner, the factors the companies have used in developing ratings and the weight given to each factor are made public.2 I am sure we will see opinions solicited and guidelines issued from both the AAO and ASCRS in the future as online rankings and ratings become more pronounced in our industry.

Do not be afraid to open the door to online communication with your patients. Create an opportunity for them to participate, interact, and share information about your practice. Ashley Frederick, a practice development specialist with Elective Medical Marketing (Boulder, CO), advises clients to consider that "The most important things people look for are non-biased descriptions, evaluations, and details from actual experiences. Consumers want a better understanding of the value of any potential new product or service they're considering, and they find reassurance in the satisfactory choices that others have made and/or learn from the mistakes (in some cases) of others."

Invite your patients to post testimonials so that your referral community extends to the Web. Physicians often receive letters of thanks from patients, and, sometimes, the correspondence ends up on walls or in a scrapbook in a consultation lounge. I suggest inviting your patients at their 1-day or 1-week postoperative visit to publicize their comments online. These living testimonials will allow patients to create a dialogue with each other about the care they received, their outcomes, and their experience. Occasionally, there may be things said that you wish were not, but you can review and approve what appears on your site's blog. More importantly, you can contact any frustrated patient in an attempt to make things right.

I subscribe to a content-filtering service that delivers online posts about LASIK, cataracts, and elective medicine to my inbox. I receive about 120 items each day, approximately two-thirds of which relate to LASIK and one-third to cataracts. As I expected, the dialogue about LASIK largely reads, "Should I have it?" and "Is my doctor's advice correct?" I have been amazed by seniors' blogs about cataract surgery. They wonder if they should have the procedure, weigh which lens to choose, and look for answers and reassurance from online communities. This audience seeks personalized information. One way to attempt to connect to seniors is to create a physician blog for your practice. These blogs must be written using tools that allow automatic re-indexing of your Web site (we are reformatting all of our clients' sites using WordPress.org) so that what you say, and how you say it, reaches your online communities quickly. The critical element is to communicate authentically. Some practices add physician blog sections and then have someone in their office ghostwrite postings or, worse, forget to post at all. The online audience lives in real time. Search out a real question. Answer a real concern. Do not use blogspace to advertise.

Today, elective vision surgery is emerging as a strong component of a practice's cataract surgery specialization. Patients network and communicate with each other frequently, instantly, and broadly. They share opinions and ideas as facts, and they are not shy about telling others what they think of you. One bad posting will not kill your practice, but ignoring the way a large section of your patient population chooses to communicate might.

Kay Coulson is President of Elective Medical Marketing, which helps surgeons grow their elective vision service lines. Ms. Coulson may be reached at kay@electivemed.com.

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