Blog | Thursday, April 30, 2015

Managing the 1-star review on physician ranking sites

A newly graduated hospitalist recounted how someone posted to every online physician ranking service—there are dozens—and gave her a 1-star ranking on each. There were no comments to which she could reply or explain, just that low ranking from what she presumed was a displeased patient.

The hospitalist asked 2 experts how she could manage the situation as part of a talk on how physician ranking websites are impacting medical practice, “Ethics and being graded by patients: Help, I'm on Yelp!” at Internal Medicine Meeting 2015.

The 2 session leaders, James A. Colbert, MD, ACP Member, and Bradley H. Crotty, MD, MPH, FACP, encouraged the hospitalist to put the issue into perspective. Dr. Crotty said, “It doesn't feel good,” to have that happen, but also asked whether it mattered to her practice as a hospitalist.

Dr. Colbert added that the audience member may be doubly safe as a hospitalist, since patients are assigned to her and only likely to uncover a negative ranking after they leave her service, unlike an office-based physician, who is more likely to encounter patients who use physician ranking sites to pick and choose where they seek care.

“Just go about your business and don't let it bother you,” Dr. Colbert advised the hospitalist.

In the world of online patient rankings, extreme viewpoints good or bad are more likely to come out, and there are usually only 1 or a few rankings posted to any one website. The issue highlighted much of the typical experience that physicians are having with online doctor ranking services, Drs. Crotty and Colbert explained.

Physicians can follow a spectrum of behavior to monitor their online reputations, Drs. Crotty and Colbert explained. One end of the spectrum, Do Nothing, is not the way to go. Other options include Googling oneself and combing the online results for reviews. This might lead a physician to encourage other patients to conduct reviews.

Some doctors have gone as far as to create their own positive reviews, sometimes with unintended results when it became obvious that they were marketing materials instead of genuine patient viewpoints, Dr. Colbert said. This also tests ethical boundaries.

Some doctors have asked patients to sign nondisclosure agreements that would restrict them from commenting on physician review websites, which Drs. Crotty and Colbert discouraged. “It promotes antagonism,” Dr. Crotty said.