Reputation management often means different things for different people, especially when you take into account their existing reputation online. For some, it means insurance against future problems. For others it means spreading good news and a positive reputation. For still others it means fixing bad things that have already occurred and doing everything possible to make them go away. Reputation management really combines all of these elements, because these days, with the prevalence of the Internet and sites like Google and Facebook, a surgeon’s reputation is out there for the whole world to see at the click of a mouse. It’s really amazing and represents a dramatic departure from the past where doctor and patient referrals ruled the day.
Even worse, today it’s like combat – you can be concurrently dealing with the review sites, a few unhappy patients, and even competitors who could be taking steps to hurt your reputation while taking similar steps to improve their own. As I often say when speaking at conferences on this subject it truly is the wild west of the Internet. But it’s a wild west that’s growing in importance. A recent E-tailing group study showed that 92% of Internet users read reviews while 89% say they influence their decision. ComScore said that consumers will pay 20% to 99% more for a service rated 5-star than 4-star. And Expedia found that good reviews of 4 or 5 double conversions over lesser reviews. And even with all the issues, consumers tend to believe a lot of what they read. Econsultancy found that 90% of people trust recommendations from people they know. That’s perhaps to be expected. But they also found that 70% trust reviews from unknown users – and that is really incredible.
At the same time studies clearly show the importance of reviews, they also show that reviews are growing and their use is growing: There were nearly 116 million US user-generated content consumers in 2008, along with 82.5 million content creators. Both numbers are set to climb significantly by 2013 according to eMarketer. And Compete.com showed that traffic to the top 10 review sites grew on average 158% last year.
But perhaps the most interesting studies of all show how complex and difficult this whole wild west can be:
A recent survey uncovered these critical statistics:
- Companies lose 10 customers for every one that complains
- 13% of people will tell more than 20 people about their bad experience
- 90% of unhappy clients will not do business with the same company again
A Kelsey Group study showed that 24% of unhappy consumers write reviews to “get back” at a provider after a bad experience. And our studies show that even with the help, guidance, and assistance of your staff, fewer than 1 in 50 or 1 in 100 patients will write a glowing review showing their satisfaction. Adding to the complexity is that the landscape is constantly changing. Just two days ago Google made a massive change – it’s suggested that it came as a result of increase antitrust and regulatory scrutiny – but that change was huge. They are no longer culling third part reviews and showing aggregating them as part of their overall star review rating – and – they are not showing snippets of those reviews either. So not only do you have to deal with how much reviews are growing, but they are constantly changing – so staying on top of things is not easy.
Of course perhaps complicating things the most is that unhappy patients will jump through every hoop possible to tell everyone about their terrible experience. In my nearly decade of doing this, I thought I’d heard it all. Amongst our own client base we have some crazy stories: The surgeon falsely accused of molesting a patient while under anesthesia – that was actually a shake-down by the patient’s husband – and the surgeon brought in the FBI and police… but the review stayed online!!! Recently, I heard about a truly crazy story. A patient had a bad experience involving side effects from a procedure to his buttocks. Well he took his campaign to the Internet and more – after posting scores of bad reviews and building anti-sites about the doctor, he actually picketed the doctor’s office for three days and paid for an airplane to fly a bad review over his professional football team’s stadium three games in a row!
Can we control our online reputations
Control is not always easy. Influence, yes. Impact, for sure. But control can be difficult, expensive, and can sometimes backfire. That’s why it’s important to create a foundation for the future. Take the right steps and claim your name space – that way if you do have problems down the road you’re in a much better position to fix them. There are plenty of things you can do to INFLUENCE and work towards controlling your reputation. First and foremost, it absolutely must start in your office. You clearly need to make sure the surgeon is doing great work and treating both patients and prospective patients in a positive and caring manner. Too many successful aesthetic physicians tell me the various reasons for their bad reputation – using them as excuses and not addressing the real issues – which is usually something going on with the physician or the physician’s practice. So start there – make sure your day-to-day is working well.
Next, remember that each and every employee who interacts with a patient or prospective patient is another opportunity to either create a good experience or a bad one. I can’t emphasize this enough! In fact, we worked with a client recent who had stellar numbers – great visibility and lots of contacts. But the surgical schedule wasn’t jamming with activity. After a lot of digging in and uncovering some very specific negative reviews, we found that a couple staff members were very rude and not treating people with respect. Replacing them turned things around.
These days, you can get bad feedback even before – or in the complete absence of – performing a procedure! If you’re rude, or short on time, or your staff is, or someone is made to wait too long, you’ll likely about it online. So what does all boil down to??? Customer service. Period. The same thing we all strive for in business – to provide an exemplary level of customer service. If you can do that – and make sure you have someone on board whose role is to ensure that standard is strived for – then you’ll take leaps and bounds towards addressing that first part of creating or keeping a good reputation.
From there, and getting into specifics, there are some things you want to do. First, buy a variety of domains, including variations of your name. Since exact phrase domains can ranking quickly and inexpensively you don’t want a disgruntled patient to go out and start ranking for your name quickly – especially if that patient has setup a really nasty site! It’s a relatively small investment, but it’s worth it.
Then, get out there and get active – blog posts, articles, Facebook updates, Tweets, Youtube videos, you name it. The more content – in its many forms – that you can get online, the better you can manage the overall content that exists. Also, and very importantly, get out there and claim all your local and review pages, standardize them, and contribute content to them as well. This is time-consuming and complex, but doing it right has a benefit – your search engine rankings improve!
Then – and honestly the advice is sometimes hard and can vary based on the specific situation – I generally advise you to be out there interacting and communicating. Have your presence known and felt. This way, you can mitigate the damages of any bad reviews because there is the context of your prior interaction. But be careful – you have to watch what you say!
So in a nutshell – start in your office, get a number of domains that are variations of your name, publish as many forms of content as often as possible, claim your name space, and interact regularly. If it sounds complicated, it’s because it is complicated!
What services are available to doctors to help doctors with their reputations and what are the risks?
Well, this is where things get a little sticky. There are plenty of services out there – some are traditional Internet marketing companies while others specialize in fixing a bad reputation. Still others are now helping customers publish positive reviews. Which type of company you work with kind of depends on your current reputation and what you are trying to achieve. If you are trying to make bad things go away, you might work with a reputation management firm. If you are trying to get more content out there, you might work with a web publishing, social media, or Internet marketing firm. If you are trying get positive reviews online, you might work with one of the firms popping up of late to help. But be careful about all of these, particularly the latter. Why?
Well, there are some definite risks involved. First, if you are trying to make bad things go away you can sometimes draw more attention to your efforts and everything gets worse! This is called the Streisand Effect and it’s something I speak about often. The name was coined when Barbara Streisand was apparently going to tremendously lengths to keep anyone from photographing and publishing pictures of her house. Her aggressive efforts resulted in even more attention and, of course, the photos were published. This happens online a lot. Someone takes efforts to make things go away and those efforts themselves become the story – adding even more negative press and drawing more attention to the whole thing – often causing the visibility to skyrocket when it may not have been much of an issue at all!
So you must be careful with this – and know that it’s not cheap to make negative items go away. Let’s just say you’ve exhausted other routes (e.g. requesting take down, speaking with an attorney, etc.) – and you’re going to have pay a company to push negative items lower. Well if you examine what that requires, you’ll see that it can get expensive. Take a look at what’s required to get your main site ranking well – time, effort, resources, content, links, citations, and more. Now think about pushing a negative site down – what does that entail? It means you need a bunch of other sites to move up and replace it – and those sites require significant effort. While the competitiveness of the terms may be less (instead of, say, facelift, you are focusing chiefly on your name) – you still need 5, 10, or more sites to do it. And this doesn’t even take into account the power of your pages on the review sites themselves. Pushing those down isn’t easy.
All this goes back again to the idea of claiming your namespace and publishing a lot of content. If someone searches for your name and you control 10 domains, two youtube channels, a facebook page, a twitter page, your claimed review pages, and more, you are in a much better position than if you were caught unaware. Bottom line: start today! Even if you don’t have issues and you’re sure you never will – if nothing more – it provides insurance for a rainy day. Or in this case, an upset patient.
So there are certainly things to worry about and issues to be aware as they relate to fixing your reputation, but where it gets really interesting is when we discuss the concept of enhancing your reputation. I got my feet wet in reputation many, many years ago and have been kind of obsessed with things since then. Back then, I owned a different company and we provided high-end reputation management. Not the kind you hear advertised on the radio – instead, this was an unadvertised, entirely word-of-mouth service. And we were good and we had big, very wealthy clients. We made bad things go away. And, it was awful on so many levels. It felt bad. I often joked that I felt like some kind of mobster trying to hide the body. But the margins were terrible too – we were fighting powerful sites – huge newspapers, government sites, and more – and it was hard and expensive. So I got out of that but started working on a way to fix the real problem – not the problem of making a bad reputation good – but the problem of differentiating fact from fiction in the review space. The problem of verification.
Many years, tons of hours, multiple patents, and some solid players later, we have that platform. But, as a one-of-a-kind solution, the only one offering legitimate compliance, it sits in a space fraught with problems. There are scores of services out there that offer to help you publish positive reviews. But going from general concept to execution is where they fall short. And since the FTC is on the case with the first prosecution for astroturfing, and review sites are up in arms, and state boards even have issues, there is a lot more to worry about than one might first think. First, there are some rudimentary and basic issues – for instance, if someone is posting on behalf of hundreds of patients, yet posting from the same location, well that’s a big problem right off the bat. Then, if they’re publishing on behalf of these patients without strict permission to do so, they are not complying with the review sites’ terms of service. They likely have issues with the FTC and even may have a problem with the state board. Are they HIPAA-compliant? Secure? Anonymous? While this is truly the wild west of the Internet, it’s particularly worrisome because it can get you in a lot of hot water. The bottom line is that picking something like this up because it’s the new fad is not sufficient to really do it right. So bottom line: be careful. A few surgeons have already been on the receiving end of less-than-clear services, and their reputations have taken a hit as a result.
I know that it’s a lot to swallow – and that’s probably why I’ve been so obsessed and excited about it for so long. It’s crazy out there on so many levels. And while it may be crazy, complex, time-consuming, and the kind of thing that has the potential to keep you up at night – if done right, it can be rewarding on many levels – from better sleep to less worries to many more patients.