An Associated Press article brings to light a new trend among doctors panicked over online ratings by patients – gag orders.  According to North Carolina-based Medical Justice, a company that provides standard waivers and social media monitoring services for physicians, “Published comments on Web pages, blogs and/or mass correspondence, however well intended, could severely damage physician’s practice.”  Undoubtedly true.  In fact, that’s that point.

So the answer that these physicians have come up with is to withhold treatment for patients who refuse to sign legal documents that prohibit them from telling others about their experience.

I couldn’t think of a more wrong-headed approach to this one.  What would your reaction be to a doctor who hands you a document that basically says – I make my patients angry all of the time, but rather than fixing the problem, I’m trying to keep you from telling others about it.  This is a big red flag!

And yet, I understand the fear.

I was recently searching for a dentist.  Went to Google and searched for options close to the office.  The first option was practically next door!  They’re close, they’re first, and they…have a review!  The review is 1 star with a single word – “Ethics” – backed up by a 300 word rant from a very unhappy former patient.

Ouch.  I moved on to the next entry on the list.

Would having signed away her first amendment rights have stopped this poster from her angry diatribe?  Unlikely.

More constructively, how should physicians react?

• Monitor:  Whether through a paid service like the one that Medical Justice offers or through something as simple as Google Alerts, physicians should be tracking how they are portrayed online.
• Be proactive with online communications:  In addition to having a presentable Web site; take a little time to plug in some information about your practice in some of the directories that cover physicians.  You may also want to encourage patients who have had good experiences to post reviews.
• Take responsibilities for the problems that patients are expressing and fix them:  We know that consumers are not well equipped to judge how good their doctors are, clinically speaking.  The result is that they often judge healthcare quality and select care providers based on patient satisfaction.  When patients get mad, it’s often the result of how they were treated (and this includes how they were treated by the office staff and in the waiting room, not only by the doctor), rather than what happened medically.
• Engage in the discussion:  When someone posts a review, you need to consider how to react.  Given an active community of participants, an individual bad review does little damage.  In the absence of that, you may consider responding.  In that response, do not attack the patient in question.  Do not respond if you cannot be conciliatory, apologize for the experience that they had, and not make excuses for the behavior of yourself or your staff.  Even better is to explain how you are addressing the issue so it does not happen again (you are doing something to fix the problem, aren’t you?), invite them to come back to you so that you can correct the issue, or offer them some other consolation for their problem.

Here’s an example of a doctor doing a much better job working through online media.  The number of reviews suggests that she’s been actively encouraging patients to post.  While not all of the posts are positive, the volume of positive feeling from her patients tells a very different story than any single negative review would do standing on its own.  Further, she’s clearly a practitioner who creates a great in-office experience, grants patients her full attention and makes them feel special.

And that’s what patient’s really care about!