Reputation Management Part 1: Understanding What Not To Do

Physician Reputation ManagementPart 1: What is your reputation online and what can you do that will burn it to the ground?

As a physician or clinic, managing your reputation online can be a tricky task. Online review sites like Rate MD, blogs and social sites like Twitter and Facebook give patients a much louder voice and longer reach than they used to have. Worse, a couple of individuals who really don't like you can have a disproportionately large voice since - unlike your generally happy patients - they're the ones who are really motivated to talk about you. 

There are ways that you can manage and control your reputation successfully, and then there are the most common responses that do much more harm than good. By way of example, here's is an example of exactly what you don't want to do and why people do it anyway.

Case study: IMD Lasers In Toronto

A few months ago, IMD Lasers in Toronto was named in an online discussion thread on Medical Spa MD with patients calling it a "horror" and saying it should be shut down... Not what you want people to be saying but, as those who are literate in the ways of the internet know, to be expected at some point if you're treating hundreds or thousands of patients a year. The problem wasn't really that IMD had some harsh comments posted about them, it was that they were unprepared, unrealistic, and unprofessional in their response to this criticism.

Note: I have never had any interaction with IMD Lasers in Toronto other than receiving the emails described below.

Unprepared: IMD was in the same boat as many physicians and clinics; they have a single, static website and no other web presence of note (more on that later). So, when anyone posts or comments with the name "IMD Lasers", it shows up on the first page of Google and Bing. When the title of the post grabs your attention like IMD Lasers should be shut down you can imagine that is something that you generally want to avoid, but if you're in a situation where you're responding to negative reviews, you're almost always unprepared since by doing some up front work, negative reviews don't harm you as much. 

Unrealistic: Facebook is a perfect example of what to expect if you have a complaint about a negative review or comment about your business; in effect, nothing. Publications that allow others to post content are not responsible for what others post and are very reticent to censor the very people who are contributing to the discussion. It's unrealistic to ask any site to delete comments simply because they're critical of you or you don't like them. You're going to have to have a better reason than that.

Unprofessional: Criticism can make anyone angry, and thinking that others are reading it can be especially frustrating. In IMD Laser's case, it appears that they're active online in promoting their business, but they've never learned the lesson that you can catch more flies with honey than with vinegar.

IMD's first reaction on reading a negative comment about their business was to go over the top, contact us via email and threaten "legal action" if we didn't comply immediately with their demands which were to remove comments that they didn't even bother to identify.

(In IMD Laser's case this email came from someone named 'Moe Dizzle' who is evidently related to the owner of IMD and sells "DJ Slipmats". I assume he's related to the owners since he signs his emails "M. Dastranj" which is the same last name as "Allen Dastranj" who claims to be the owner or IMD Lasers.)

The fact that we received such a harsh email out of the blue made us take a look at the comment thread that IMD Lasers was complaining about, (You can read it here: IMD Laser Clinic In Toronto) but when we read through the thread we found a number of suspicious comments in the thread that triggered some red flags and take a closer look. For example, here's a comment left on the Medical Spa MD thread:

I think IMD laser clinic is AMAZING! When I came to the clinic it was like home. Everyone was so nice and the service was amazing! After i finished my treatment i looked 20 years younger. It was amazing. IMD Laser Clinic is the best. It was worth my money. :)

A very happy costumer of IMD Laser Clinic

And here's a review of IMD Laser left previously on (a Canadian review site) on August, 5 2010: Link

IMD Laser Clinic is AMAZING!!! It has amazing services and amazing doctors! The clinic made me feel like i was right at home. When i finished my treatment i looked 20 years younger!!!! I was just amazed!! IMD Laser Clinic IS THE BEST!!!

A very satisfied costumer of IMD Laser Clinic

Now, is it possible that "amazed" Kristy/Christie left almost exactly the same comment on two different sites a year or more apart and that she forgot her own name, but it doesn't seem likely. It's much more likely that someone is busily leaving phony comments promoting themselves.

Take a look at all of the reviews promoting IMD Lasers on another review site here:

Anything jump out at you? How about this: There are seven 5 star reviews left over a two year period but all of the reviews are... posted on only 4 days (one days has 3 reviews), are glowingly promotional with lots of exclamation marks, are marked 'Not Helpful' by other reviewers, and contain numerous similar grammatical errors. Any red flags there that might lead someone to believe that they weren't real?

In fact, after reading all of the wildly glowing reviews posted on Medical Spa MD under different names promoting IMD, I could see that that (big surprise) every single positive review originated from IMD Laser's Toronto IP address

IMD claims that all the positive comments were IMD patients posting positive comments from computers inside IMD's clinic using their computer.  : )

The fact that IMD Lasers is both abusing this site and our intelligence isn't doing them any favors. Since posting self-promoting comments under multiple alias's is very much against our terms, their IP address was banned and a notification was placed on the thread.

Generally, if we get a specific request from someone who has done their homework and has a legitimate claim that a comment violates our terms, we'll take a look at it. We have removed many comments and entire threads... but posting self-agrandizing comments under different names and then threatening to 'contact a lawyer' to have everyone elses comments removed is exactly the wront tactic. It destroys any credibility or good will that they might have garnered had they been smarter and used a less confrontational approach. After all, we've had more than a little experience with litigation and threats from others who want to curtail anyone voicing an opinion they don't agree with:

Then there's the Streisand Effect, named after the famous singer Barbara Streisand.

From a post on Understanding the Streisand Effect.

In 2002 a photographer studying coastal erosion along the California coast took thousands of photographs of the coastline from a helicopter and had put those images into an online database to aid in awareness of the issue and, hopefully, have the public help spot problem areas and address them.

However, one of those photos captured the back of Streisand’s California home, which was adjacent to a cliff at the ocean’s edge.

The image was just one of over 12,000 images in the database but Streisand was still upset about its inclusion and public posting. In early 2003, she filed a lawsuit against the photographer and several other companies involved seeking some $50 million in damages.

The result was ugly. The story, and the photo, spread like wildfire across the Web, Prior to the lawsuit, the image had only been accessed six times and five of those times were by Streisand, her legal team and her neighbor. Now, Google Image Search reports there being thousands copies of the photo available online (in many different variations), likely garnering tens thousands of views per day even now.

It was after this backfire that the term “Streisand Effect” was coined by Mike Masnick at Techdirt.

...Anytime you try to silence speech on the Web, no matter how legitimately, this is the risk you take. It’s just a matter of how great the risk is.

The fact that IMD Lasers stuck their foot in it by being belligerent and is being used to illustrate this post is just one example of how you can get more attention than you want by thinking that no one will shine a light on your activities or emails. 

For example, if you send an email or letter, there's absolutley nothing that prevents the recipient from posting all of that information online across multiple sites. In fact, it's pretty common. If you're going to take any action, be aware that it's going to be public and that the recipient will likely have a microphone.

There are almost always better options since it's almost inconceiveable that a comment or post is actually that harmful to your business. Just because you don't want someone reading a negative comment doesn't mean that you can prevent it, or even that you should try. 

It's important to understand that most issues regarding your clinic or professional reputation on the web you are going to be dealing with reviews and comments from your patients, sometimes anonymously. In most cases readers will dissregard anything that feels like it's an obvious 'smear campaign'. However, the most problematic reviews are often from someone who has an axe to grind. They might be a patient but they might also be a disgruntled employee that you fired or even a competitor. In these cases you're going to want to be more proactive.

What's protected speach?

Adittionaly, as long as the review or comment is someone's opinion they can say pretty much whatever they want (in the US at least) and they don't have to qualify it as their opinion in the comment. So, if someone want's to post that they think that you're a jerk (even though you're not), uneducated (even with your Ph.D.) and short (even though you're 7'4"), they can. It's their opinion. It doesn't have to be correct, wise, or supported by any facts... and they can say it as many times, in different places, as they want.

Read the Medical Spa MD Q&A on online defamation for physicians here.

What's not protected? In short, of someone claims something that is demonstrably false AND that they know that it's false AND that they do it with the intent of inflicting harm on you AND it does causes damage that you can prove... If all of those criteria are met it's possible that it's not protected and that person may be committing liable. However, that is an incredibly high bar of proof and if any one of those claims are missing it's not liable. That's why you don't see bigger companies engaging in threats of legal action against people that post negative reviews. Bigger companies know that they can't win. It's usually a smaller company or individual who feels personally attacked that makes these claims because their ego gets involved and they feel threatened.

So what should you do?

In part two of this post we're going to go through what you should be doing right now to make sure that you don't ever have to worry about this.

Read: Medical Spa MD: Online Defamation FAQ

Need to protect your reputation? Check out Frontdesk's Reputation Protection for Physicians