Online Reputation Management for Doctors
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Online Reputation Management for Doctors
Curated and Written Articles to help Physicians and Other Healthcare Providers manage reputation online. Tips on Social media, SEO, Online Review Managements and Medical Websites
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Three Things Physicians Should Know about Social Media

Three Things Physicians Should Know about Social Media | Online Reputation Management for Doctors | Scoop.it

Like many Americans, physicians have discovered the value of social media. Whether they seek to market their practices, educate consumers about health concerns, or engage with patients online, many physicians see the potential in an economic way to reach large audiences quickly via Facebook, Twitter, LinkedIn, YouTube and other sites.


Over 70 percent of family physicians and oncologists use social media more than once a month, according to one survey. Another benefit, clearly, is these sites allow physicians to keep up with news and trends relating to health, medicine and patient care.


Physicians, and all healthcare professionals, should understand the risks of using social media improperly, as these risks could easily outweigh the benefits. Using social media inappropriately could lead to a liability suit that could damage a physician’s reputation or could cause the release of confidential patient information.


The release of patient information would violate HIPAA, which requires physicians and all healthcare entities to safeguard what it calls protected health information (PHI). The law defines PHI as any individually identifiable health information that medical practice or any associate of the practice maintains or transmits in any form. Such a broad definition makes physicians, anyone working for the practice and any vendor who contracts with the practice potentially liable if PHI is released to the public.


Several organizations, including the AMA and the American Association of Family Physicians, have published guidelines for social media use. Another excellent source of such guidance comes from the Federation of State Medical Boards, the group that represents the agencies in every state that discipline physicians. The federation’s 14-page Model Policy Guidelines for the Appropriate Use of Social Media and Social Networking in Medical Practice, is designed to educate state boards on social media. In one section of the guidelines, the federation outlines its recommendations for physicians who use social media and social networking personally and professionally. It recommends following these three steps, saying physicians should:


1. Limit discussions with patients about medical treatment. Therefore, they should never do so on personal social networking sites because anyone with access to these sites could view a physician’s comments about a patient’s care.


2. Provide no information that could identify patients because doing so could be a HIPAA violation.


3. Assume all risks related to the security, privacy and confidentiality of their posts when posting online. Assuming such risk means that when moderating any website, physicians should delete inaccurate information and posts that violate the privacy and confidentiality of patients or that are unprofessional.


Perhaps the best way to sum up the federation’s advice is this — always be professional. Always follow the same principles of professionalism online as you would offline. Use separate accounts for personal and professional social networking sites and for email. This way you can maintain professionalism and confidentiality in your professional postings and still enjoy personal, more casual conversations where appropriate on your personal sites.

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Physicians Shouldn't Fall Prey to Unsustainable Stress

Physicians Shouldn't Fall Prey to Unsustainable Stress | Online Reputation Management for Doctors | Scoop.it

New developments in science and technology all but guarantee that barring some catastrophe, you're likely going to live longer than you currently presume. Perhaps you'll reach 100. Medical breakthroughs already in the pipeline, that seem as if they are more akin to Star Trek than today, promise an astounding new age.

Coming developments

• Major victories in the onslaught of AIDS, including genetic therapies that offer a high cure rate.

• At least partial recovery from spinal cord injuries via the development of artificial nerves.

• The development of artificial body parts that function as well as or better than the original parts, and are visibly undetectable as synthetic.

The unforeseen

Even if you can't see it now, you might find yourself taking time off to travel the world. You might retire and then come out of retirement a few times. At 86 or 92, you might decide to run for political office. After all, there will be a large constituency of your contemporaries who will have no problem voting for a fellow octogenarian.

While stress can certainly shorten a life span, most people still realize something close to their estimated life span. What counts is the quality of your life on the way there. Suppose I told you that you would live to be 116, but it would be with the same amount of stress that you're experiencing currently. Would you do it? Would you want to? The quest of most rational people is to live a long, happy, healthy life with relative grace and ease.

Dead men do tell tales

I found the observations of Dr. William R. Maples, PhD, in describing suicide victims to be captivating. Maples, a forensic researcher, diagnosed how and when people died. In "Dead Men Do Tell Tales," he said, "Many of the skeletons that come into my laboratory belong to suicide victims who behaved like shy hermits in their final hours."

"Usually they are found in remote out-of-the-way places. People often go to some hidden place to kill themselves, whether from a desire to act alone and unhindered, or because they wish simply to disappear in solitude, spending their last moments in reflective silence."

Would these individuals have killed themselves if they had attained reflective silence throughout their days? Was their wish to die alone, merely an ill-advised "solution" to their stresses? How would their lives have unfolded if they knew effective ways to find solace and tranquility in the here and now, at work, at home, and in all places in between?

Be true to oneself

Physicians are experiencing greater levels of stress, and less control over their professional lives. Not only that, stress has become the malady of our generation, and it's desirable not to follow the crowd. Instead draw upon your experience, knowledge, and instinct to carve your own path; you will encounter less stress if you are less swayed by prevailing norms. Think and act based on your ever-developing internal guidance system.

Certainly you accept and rely upon input from the outside world; you can't help but do so. You also determine what is relevant to you and what is not, and ultimately, what is appropriate for you and what is not.

When you fully acknowledge the circumstances and events as your life unfolds, and when you fully acknowledge your ability to make appropriate choices, you feel a greater sense of control, every day, and throughout your life — which could well extend for many decades.

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Online Reputation Management: Doctors and Dentists Guide to Fixing Bad Reviews

Online Reputation Management: Doctors and Dentists Guide to Fixing Bad Reviews | Online Reputation Management for Doctors | Scoop.it

The number of reviews for health care providers online is growing exponentially and at an accelerating pace. Betting against this trend is foolish, yet managing your reputation online can be a time-consuming task. And once effective cease & desist letters to remove misleading or false reviews can receive large amounts of negative publicity from online newspapers and avid defenders of CDA 230 of the Communications Decency Act – which holds harmless those companies hosting such
user generated content.


If you search Google for your name you will see the following:

  • Your own website (hopefully).
  • Various review sites such as Insider Pages, Dr. Oogle, Yelp and others.
  • Search directories happily capturing traffic on searches for your name.


Review sites and search directories are trying to sell advertisements based upon people searching for objective reviews on your practice and others offering the same service. That means your current patients looking up your phone number or address in Google are blasted with ads for potentially negative reviews and ads from competing practices in your immediate neighborhood (Google is getting very good at Geo-Targeting down to the zip code).


A more alarming situation is if a review site has one or more bad reviews visible associated with your practice.


Many private practitioners are under the assumption that the web traffic they get is from searches for keywords such as “Dentist San Francisco, Ca” (Broad Keywords) by examination you will you’re your name (Brand Keywords) being actively and regularly searched by your current patients base and potential patients.


If you have patients, chances they ARE or will be talking about you on the Web.


You cannot really 100% stop bad reviews on review sites but you can execute a strategy to defend yourself and voice your own perspectives as balance, hopefully a dominant perspective that is the primary “voice” of your name & brand online. The irony is that private practices have been toiling for years (some decades) to care for their patients, having collected numerous Thank You letters and cards.

So, What Can You Do?

Ideally, this is handled by having hundreds of pages that you control that Google can find under a search for your name.


Do this by creating a Blog. Blogs are cheap to build and easy to maintain. Search Engines also love the dynamic nature of a Blog – when’s the last time you added new content to your website as is required now of competitive keyword markets on Google? Chances are, a low-cost Blog will eventually out-rank your static website (and many others) over time. Best of all, you’ll show your community and your patients (as well as future patients) that you care enough to have a voice online and adopt new technologies.


A blog offers a great avenue to pass on details about your practice such as new equipment you spent so much to get or new skills you or your staff have attained.


Transcribe your patients’ testimonials online and on your Blog. And add functionality on your Blog where your patients – if they have a gripe – can come to you first. Because if they have no alternative but to go onto another site – that negative review (even if the patient was having a very bad day) can be permanent!


Every page on a blog can be set up to be visible to the various searches on your name to where it can in time produce hundreds of potential pages that can be found under a search for your name.

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5 Ways to Manage Your Online Reputation

5 Ways to Manage Your Online Reputation | Online Reputation Management for Doctors | Scoop.it

Online Reputation Management for Doctors can be more crucial than  any other industry. In this information age reviews can make or break a practice. Follow these tips below and get the recommendations that match your skill set.


1)      Ask Your Happy Patients to Write a Review: Don’t be afraid to ask, because it certainly won’t hurt if your patient is leaving happy. Follow up with your patients – you can ask them directly for a review, or you can point them to a  website like healthgrades.com, vitals.com or ratemds.com


2)      Post Your Positive Reviews: In your office on a bulletin board, your website, blog and social media. The more attention you drive to the good, the less attention will be given to the poor.


3)      Google Yourself: Search for your name both for text and in images. Also, set up aGoogle Alert and you’ll get new results emailed to you based on the search criteria you specify. You’ll be notified immediately if any new reviews pop up.


4)      Get Active on Social Media: Social media is more relevant in today’s purchasing process. Get engaged with your followers to foster better relationships with the people who care enough to post online about their experience.


5)      Respond to Negative Reviews: Don’t just ignore them, because they won’t go away. Responding to negative reviews shows that you care about your patients, even and especially about the ones that left unhappy. But don’t just apologize; you need to make sure your response is well thought out, sincere, and that it addresses the issues and explains why future patients will not experience the same issues in the future.

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Physician Online Reputation Management

Physician Online Reputation Management | Online Reputation Management for Doctors | Scoop.it

Physician review sites like Vitals, RateMd and Yelp have become increasingly important in the digital medicine revolution.  Patients are relying more and more on the input of other patients to help them make decisions on a medical specialist.  In most instances, prospective patients are finding a physicians website and then cross referencing their services with review sites to solidify whether or not they should make an appointment.  Ensuring your online reputation is managed properly has become a science in and of itself.


Sadly, review sites have become a Pandora’s Box for disgruntled consumers.  One study showed that dissatisfied consumers are 3 times more likely to leave a review than satisfied customers.  This is likely due to the cathartic feeling many consumers may feel after bashing a product or, in your case, a physician.  After that review has been posted many feel vindicated in knowing they may have permanently damaged your reputation by leaving an indelible smudge on your online reputation.


So, how do you avoid this seemingly inevitable pitfall?  First, let’s review what NEVER to do in regards to reviews.


Directly Responding To A Negative Review


For many physicians seeing a negative review immediately puts them on the defensive and they feel the need to publicly refute these claims.  This is one of the worst mistakes you can make.  Publicly addressing this gives other potential patients the idea that you are petty and self-righteous.  I know it may be hard to sit idly by while a patient misrepresents a series of events or experience with your practice.  However, going on the message board and defending yourself lets patients know you can more about your online reputation than you do your patients.

Inherently, we know your online reputation is important but the potential patient can never know that.  Your results and reviews have to seem organic and not micro managed or orchestrated.


Instead, try and do the research as to what patient left that review.  It may take some looking through your records, but with some digging you can usually narrow it down.  Once you have established who the patient is, reach out to them directly whether it be via phone or email.  Let them know that you saw their review and that you are aware of their disappointment and vigorously apologetic.  Offer to rectify the complaint with another consult at no cost or recommending another specialist for them.  Do not be afraid to be personal and say things like, “As a medical professional my primary concern is my patients.  Seeing reviews like this really makes me evaluate my bedside manner and helps me improve my demeanor for future patients.”


The most important thing to convey is that their grievance has been taken into consideration and will help you in the future.  Many times the patient will supplement their original review and note that you reached out to them personally.  Many others will remove the review altogether.


Patients Can Smell It From A Mile Away


Most physicians believe that a slew of gleaming 5 star reviews is the best way to capture new patients from a review site.  Wrong.  By nature, most people are inherently skeptical and pessimistic.  Many only visit review sites to validate their preconceived notions of a product or service.  Sadly, no one believes in perfection.  If patients see nothing but overwhelmingly positive reviews about you they are going to become suspicious.

This may seem counterintuitive as 5 stars is always better than 4 stars.  However, it is a matter of plausibility.  A 4 star review is often more plausible if the only complaint was something a patient would reasonably expect.


For instance, an effective 4 star review would be:


“Dr. Smith was great.  He explained why I was in so much pain and took the time to go over all of the things I could do at home to relieve my pain.  We also discussed surgery but he wanted to wait and make sure we had gone through all of the conservative treatments first.  My only complaint was that my appointment was at 5:30pm but I was not seen until 5:45pm.  Other than that Dr. Smith was great and I would definitely recommend him.”

You lost a star, but it is negligible because the review was so positive.  The only complaint was a longer wait time than expected.  However, this is nothing new to anyone who has ever been to a physician’s office.  The key here was plausibility.  As a potential patient, I believe this person is real and I believe their assessment of their interaction with you because of the slight imperfection.


Leaving Fake Reviews


Many practices have taken to leaving fabricated reviews that reflect positive reviews of patients that never existed.  Although this may seem like a good idea it is irresponsible in terms of ethics.  I know it seems like an easy way to bolster your reputation but I urge you not to engage in this shameful practice.

Also, many review sites have become savvy to this tactic and have begun tracking ISP’s to determine whether or not these reviews are valid.  If a review site sees an abundance of reviews being left from the same ISP and location it may flag your page.  If prospective patients find out you have been lying about your reviews they are also going to wonder what else you may be lying about.  Your credentials?  Your skills?  Your expertise?


Furthermore, there are legal ramifications for leaving fake reviews:

The FTC has the following guidelines for patient reviews:

  • All reviews must be truthful and not misleading in any way

  • Even paid endorsements are considered to be deceptive if they make false or misleading claims


If the FTC or BBB find that your practice has been posting fake or deceptive reviews online, or that they are being compensated for the activity, you could face a hefty fine.


This is also true for leaving negative reviews on competing physicians review sites.

Many review sites, such as Vitals, will allow you to hide or remove 1-2 reviews that you feel are invalid or fake.  Other sites allow you to contest a review if you can prove that it is not genuine.  It is always best to attempt to hide these reviews first as attempting to deal with the Customer Service teams on these sites is an exercise in futility.  Generally, their response is that they are not responsible for the reviews left on your page as long as the site has deemed them to be credible.  “Credibility” is usually based on a proprietary system that the site uses to crawl reviews.

Another thing to be aware of is that Yelp has a filtering system that posts some reviews and not others, according to a recentForbes.com article.

“My wife, a Realtor, had a similar experience: ‘They seem be wary of first-time reviewers. If your first review is negative then they let you post other reviews, but if your first review is positive then they remove it. The same goes if all your reviews are positive.’

She went on: “I called Yelp after a business associate posted a positive review about me which was later removed. They hinted that if I advertised on Yelp this may not have occurred.”

A case can be made that this borders on extortion.


A Practical Solution


With many of my clients I have faced the daunting task of cleaning up their online reputations after years of mismanagement.  In response to this I created a simple process that has worked incredibly well.

I created a card that is slightly bigger than a business card that physicians give to a patient as they are leaving the office.  This card thanks them for coming in, includes the practices phone number and also encourages them to leave a review on one of the physician review sites and includes a short link to each site.

The most important thing about using this system is what I call “The Moment”.  This occurs when the patient is exiting the exam room and you know that they are ecstatic.  It is at this point where you need to break the confines of the doctor patient relationship, look them in the eye, shake their hand and genuinely thank them for coming in.  During this time is when you say to them, “I am truly thrilled that you are so happy.  Here is a card with my number on it.  If you need anything please do not hesitate to call.  Also, if you want to leave a review just take a look at the back of the card.”

The patient is so flattered by your handshake and sincerity that they are now exceedingly likely to leave a positive review  The key is to encourage the right patients to leave reviews.  These are the patients that you know are happy and are willing to go the extra mile for you.  The success rate of these cards is astounding but it is predicated on your ability to captivate them in “The Moment”.

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5 Tips for Improving Your LinkedIn Profile - CompHealth

5 Tips for Improving Your LinkedIn Profile - CompHealth | Online Reputation Management for Doctors | Scoop.it

Do you use LinkedIn to connect with colleagues? This social network is a great way to display your work experience, showcase your unique skills and find a new position at a hospital or other healthcare facility. Whether you’re looking for a new job or just want to make your work history more appealing, these five tips can help you improve your LinkedIn profile:


  1. Include a professional headshot with your profile. The first thing people will notice is your photo, so make sure it’s high-quality and reflects the industry in which you work. While it’s not necessary to have a studio-quality photo, your profile picture should have a simple, monochromatic background and be cropped from your shoulders up. Business attire such as a blazer, collared shirt and tie is recommended, but a photo taken in your lab coat is also appropriate.
  2. Use the headline section to list your current position or promote the job you’re looking for. By default, LinkedIn will fill this section with your current job. However, you can customize it by clicking the Edit button at the top of your profile. If you’re in the market for a new position, include a description with specific keywords employers are looking for. For example, you could write “Family practice doctor with 20 years of clinical experience” so that your profile would show up in both LinkedIn and Google search results.
  3. Write your descriptions in clear, conversational language. Though your colleagues may be familiar with technical terms and medical acronyms, a hiring manager at a hospital or clinic may find these confusing. Spell out even the most common abbreviations, like PA or NP, on first reference and list all relevant experience in the summary section of your profile. Be sure to write in the first person at all times to keep your descriptions friendly and easy to read.
  4. Be sure to include contact information on your profile. Prospective employers and other friends can get in touch with you through InMail (LinkedIn’s email system), but the contact information section on your profile is a great place to list an email address, relevant blog link or even a cell phone number if you’d like to be contacted. Remember that everything you post in this section is public, so keep your contacts (and prospective contacts) in mind as you update it.
  5. Set a customized profile URL you can share easily. If you haven’t already done so, edit your profile URL so it includes your name instead of letters or numbers. Doing this makes your profile more professional and also allows you to add the link to your signature line or blog so others can connect with you on LinkedIn.


These simple tips can help your profile stand out to both colleagues and employers — and they can also help you gain more confidence in promoting the unique talents you bring to the healthcare industry.

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Google+ for Physicians: A Free Tool for Reputation Management

Google+ for Physicians: A Free Tool for Reputation Management | Online Reputation Management for Doctors | Scoop.it

With the expansion of rich information found on social media and review websites, the modern patient is empowered like never before. Researching physicians is as simple as browsing for a car or laptop: search engines and rating websites provide current or former patients a platform for sharing their experiences. Reputation management is a global process that begins and ends with networking sites like Google+. Social media is changing the healthcare game into something much more interactive. That is an exciting concept for professionals looking to amp up their referral systems.


Doctor review websites


Why Online Reputation Matters in Healthcare
People are increasingly referring to mobile devices to perform research online. A study by the Pew Research Center suggests that one in five people who use the internet to find a doctor rely on physician ratings.


The flip side of an internet presence is the potential for damaging feedback – that is the basis of reputation management. Any brand or physician should habitually search its name on Google to look for negative reviews or comments. In the medical world, this is how doctors keep up on what their patients are saying about them and what future patients see.


How does Social Media Fit into Healthcare?


A social media page on Google+ adds a way for doctors to better connect with the public. It’s an upbeat way to manage professional reputation and improve patient care. Patients see the bond with their physician as a very personal one. They appreciate the opportunity to vocalize their satisfaction or frustration with a specific physician or experience. Social media creates an e-patient scenario that allows the physician to promote healthy living, generate trust, and market the healthcare brand. For a doctor, time is in short supply, but fostering a positive reputation online allows you to stay ahead of the curve.

Building a Social Media Voice


The process of developing a “voice” will differ among physicians and service lines. A doctor with a full practice might spend only one hour a week on Google managing his online reputation, while a new cosmetic surgeon will need to commit much more time to creating a brand. Other doctors use their online voice to educate and promote wellness as a way to further their patient’s quality of care. Most businesses, medical or otherwise, realize the power of a professional website. Social media is just another tool to amplify that voice.


Doctor on twitter


What about Referrals?


Engaging with one person through social media translates into interaction with friends and family at the same time. Social media takes word of mouth to the next level. Consider some practical tips for using social media healthcare to enhance referrals:


Research your options – This is critical factor. Many healthcare facilities and organizations have specific rules and guidelines about social media. Take the time to investigate social media polices that affect your strategy to build an online presence.


Privacy is key in social media – Patient privacy is paramount, but it is easy to lose sight of that fact when interacting with a computer screen. Keep in mind the number of eyes that see posts on a social media page. This includes other patients and family members in addition to healthcare administrators, government bodies and content journalists.
Disclaimer, disclaimer, disclaimer – Include an upfront disclaimer on all social media healthcare pages and posts. If communicating with patients through social media, such as during an hour-long Q&A on Twitter, point out that you are not providing a medical diagnosis or treatment.


Seek expert advice – Companies that specialize in reputation management are popping up every day. Find a firm that creates strategies to develop a social media voice. They can handle some of the preliminary legwork and ease you into the process.


Don’t mix business with pleasure – Keep separate social media accounts for your personal communication. If you use Facebook or Twitter to stay in touch with friends and family, don’t use them to foster a professional online reputation. This is as much a safety concern as business advice.


Conclusion


There is a new generation of patients out there, and they are more than just internet-savvy – they are internet-reliant. Doctors need to understand that reputation management and generating referrals online are now a concrete component of digital marketing. The internet, and specifically social media, is part of the modern medical practice.

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10 reputation management tips for doctors - Social Media GP

10 reputation management tips for doctors - Social Media GP | Online Reputation Management for Doctors | Scoop.it

A patient complained about a doctor on Facebook and generated a lot of online traffic. The story was reported in the newspapers. The Medical Board started an investigation. Pending the outcome the doctor relocated to another city. This left the local community without a doctor as no replacement could be found.


A year later the doctor’s name was cleared by the board. But the damage was done. And for many years the article kept showing up in Google search results in relation to the doctor as well as her old practice.


The good news is that I made this scenario up. The bad news: reputation damage can happen to all of us. Pro-active online reputation management should be part of a healthy risk mitigation strategy.


Here are some simple (ethical) tricks I have used to manage my online reputation and improve my Google rankings. You can do it too, it’s easy. It is applicable to your personal brand (your name) as well as your organisation.

1. Always respond to customer needs and expectations

Prevention is better than cure. Our managers act on complaints immediately, as negative comments have the potential to spiral rapidly out of control, especially online. Here is an example of how not to handle a social media crisis.


Our quality assurance committee starts its meetings with a ‘good, bad and ugly’ review of the past month. The group looks at any problems or feedback received, including e.g. Facebook comments. We’re not perfect by any means, but this approach allows our organisation to improve patient services on an ongoing basis.

2. Create, promote, and update your own online content

Develop a professional website but don’t stop there! Start a Blog. Create social media profiles on LinkedIn, Twitter and Google+, and update your profiles regularly. This will improve search engine rankings so your own content will show up first. Use namechk.com to find out which social networks are available.


3. Interconnect your online profiles


This will further improve rankings. Splash pages like about.me help to connect your profiles in one place.

4. Encourage constructive criticism and respond timely to feedback

Engage when people post comments. Respond preferably on the same day. Look at feedback as free business advice. Thank the reviewer and explain your point of view. We have learned from the comments on our website and practice Facebook page.

5. Don’t argue online (and offline)

Set an example. Be a leader. I know this is not always easy, but an angry response is as bad as no response. Be aware that many clients are watching. Avoid deleting comments as this will usually not help your case.

6. Monitor the web

Google yourself and your organisation at least weekly. Set up Google alerts for your own name and other brands or topics you would like to follow. Free services like peekyou.com,Socialmention.com, and Veooz.com can be helpful. There are lots of other tools to watch your web presence.

7. Correct and improve information on external sites

Most sites will update your details at no cost. Some sites like HealthEngine or HealthOptions Australia may have added your name and address but will only allow you to update details or improve your listing after paying a subscription fee.


If you feel a review about you or your organisation is incorrect or unfair ask the owner of the website to make amendments. If that’s not an option request to write a comment on the feedback. Google will only remove reviews if they contain unlawful content, are spam, off-topic or if there is a conflict of interest.


Google offers useful tips about how to respond to reviews.

8. Improve positive content, push down negative content

There are many reputation management services on the web. They improve rankings and make it harder for negative content to show up high in search results. Brandyourself.com is an excellent free reputation management tool to improve your personal search results. You need to have a social media profile and a website before you start.


9. Be ready to engage with traditional media

Have an official spokes person. Consider media training. I like to give journalists a written summary of the main message our organisation wants to bring across.

10. Know the rules

The Guidelines for advertising of regulated health services explain the advertising limitations under the ‘Health Practitioner Regulation National Law Act 2009’. The Good Medical Practice Code of Conduct of the Australian Medical Board includes principles about how to respond to complaints. If in doubt, ask your medical defence organisation.


Most social media networks, including Facebook have rules. This article is a great illustration: Kicked off Facebook? Here’s what happened. If you want to know how not to use social media – and stay out of trouble – have a look at the AMA social media guidelines.

Reputation management will take time and ongoing commitment. We’re improving our strategies all the time – learning from our mistakes. Let us know how you go! Tips are always welcome!

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Transitioning to a Direct Primary-Care Medical Practice

Transitioning to a Direct Primary-Care Medical Practice | Online Reputation Management for Doctors | Scoop.it

In 2013, family physician Bruce Jung found himself at a professional crossroads after leaving his position at a Corbin, Ky.-based community health center that he cofounded. He and his wife wanted to stay in the area to raise their six children but he was wary of navigating the complicated healthcare landscape as a solo practitioner.

"My wife heard about direct primary care (DPC) and we became fascinated with the concept," says Jung. "Being free from the hassles of working with insurers was very intriguing."


After doing some research and consulting with former colleagues, Jung embraced the DPC model and opened his solo practice, The Doc Shoppe, in January 2014. His patients have the option of paying a monthly membership fee in exchange for unlimited access to routine and preventive services, or enrolling on a fee-for-service basis. The practice does not work with any private or government insurers.

Opening the practice was a risky move that called for a sizable upfront investment and convincing potentially skeptical patients to try a nontraditional approach to managing and paying for their healthcare. More than a year later, Jung has yet to see a profit but remains convinced that he made the right move.


"I've never enjoyed practicing medicine or developing relationships with patients more than I do now," he says. "I feel like I am getting back to the heart of medicine with direct patient-to-physician interaction in terms of both healthcare and reimbursement."


HOW IT WORKS


Jung is a firm believer in price transparency, a concept that fits well with direct billing under the membership model. His website prominently displays the costs of various categories of membership as well as à la carte prices for office visits and lab services and a link to the complete price menu.


"I remember a patient in my prior practice asking me how much her visit would cost," he says. "I realized that I had no idea and even my CEO did not know how much this person would have to pay for [her] visit. It got me interested in looking at other models."


Under The Doc Shoppe's membership plan, patients pay a one-time $50 registration fee and sign up for automated bank transfers to cover their monthly payments. As members, they have unlimited access to primary and preventive care as well as routine lab services. Jung gives out his cell phone number and offers same-day and next-day appointments as well as virtual visits.


To cover catastrophic events, Jung recommends that patients supplement their membership with a high-deductible, low-premium insurance plan. Ideally, that plan would be attached to a federal Health Savings Account (HSA), which allows consumers to save pre-tax dollars to pay for qualifying medical expenses. However, under current IRS rules, joining a DPC practice disqualifies a patient from having an HSA paired with a high-deductible health plan. That's because it defines DPC plans as health insurance and HSA holders are prohibited from having a second health plan.


That may change soon, according to the lobbying group Direct Primary Care Coalition, which reports that seven states have passed legislation making DPC distinct from insurance products and several members of Congress have requested that the IRS reconsider its definition. The Washington Health Benefit Exchange, for example, offers consumers in the Seattle area the option of joining a DPC medical home combined with a qualified health plan.


With or without an HSA, Jung makes the case that combining a high-deductible insurance plan with membership is more cost-effective for patients than traditional insurance. Instead of putting off doctor visits to avoid paying out-of-pocket until their deductibles are met, members tend to take care of problems as they arise, potentially preventing more serious health problems down the road.


In addition, patients may get higher quality care and more time with their clinicians than in a traditional practice, says Jung, because DPC eliminates the time and costs associated with working with third-party payers.


FINDING A MARKET NICHE


Jung's research on direct primary care yielded plenty of useful information about the basic membership model, but little on how it might work in a low-income community like Corbin. While most membership models he found were located in affluent or suburban areas, the median household income in Corbin was $31,746 in 2013, more than $10,000 below the state average, and more than $20,000 below the national average, according to the most recent U.S. Census data.

"The only other models in indigent communities that we looked at were Federally Qualified Health Centers and they depended on entitlement funds and grants that I didn't have access to," he says. "To make this model work here we knew we would have to alter the model a bit and keep costs down even more."


Jung wanted to help some of the same low-income and uninsured patients he had cared for in his previous position at Grace Community Health Center. He decided to target a niche in the market made up of patients who earned too much to qualify for insurance subsidies under the Affordable Care Act, but too little to afford private insurance premiums that covered most primary-care services.


"These patients are looking for a plan they can afford that would still cover their needs," he says. "It makes sense for them to combine a high-deductible plan with a membership with us."


FINANCIAL CHALLENGES


In order to make membership affordable for his target population, Jung keeps overhead costs down by renting a small office space and hiring only one other staff member — a highly qualified nurse practitioner. He also negotiates with lab facilities and other providers for volume discounts on services for his patients.


"We wanted to offer the lowest possible membership rate while including as many services as we can," he says. "For $50 per month they get unlimited access to our office as well as hundreds of lab tests at no additional cost because we've been able to negotiate wholesale prices down to the bare minimum."


In addition to labs, Jung has been able to lock down discount rates with providers of ancillary services, such as radiologists, for things like computerized tomography scans, magnetic resonance imaging, and colonoscopies.


Recently when a patient needed a foot X-ray, for example, Jung called two local hospitals and a diagnostic outpatient center and was quoted rates ranging from $100 to $600, often not including the radiologist reading. Thinking he could do better, he called on an orthopedist colleague who had an X-ray technician on staff.


"He said he would do this patient's X-ray for $45 and the patient could bring the films back to me to read," says Jung. "The patient ended up saving 12 to 15 times the cost of an X-ray at the hospital, which paid for a whole year's membership."


Other cost-saving measures included working with a local bank, rather than big credit card companies, to handle automated transfers of membership fees from patient accounts to the practice. The bank's $10 monthly rate and 5 cent transaction fee are much lower than most credit card rates.


Still, costs continue to outstrip revenue, says Jung. He has enrolled just over 240 members so far, out of 450 patients in total. His goal is to reach 600 patients to 700 patients per provider in order get out of the red.


"I was told by more experienced physicians that this process would take two years and cost from $50,000 to $200,000," he says. "It looks like we will be on the high end of that and definitely hit the $200,000 mark."


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This surgeon embraces social media. Here's why she converted.

This surgeon embraces social media. Here's why she converted. | Online Reputation Management for Doctors | Scoop.it

I am converted. Like many doctors, I was very leary of social media, wary about using it, skeptical of its professional value. Especially Twitter, but really all of the platforms. No longer: I have embraced social media, and it has embraced me.

I feel a little bit like Dr. Strangelove, only the subtitle is now “How I Learned To  Stop Worrying and Love Social Media.”

Like most converts, I find myself an enthusiastic proselyte, spreading the good word to friends and colleagues, regaling them with my new-found experiences using Twitter, Facebook, LinkedIn and the like. Discovering more sites and platforms, like Sermo, Doximity, Docphin, and Medstro, to name a few. (Disclosure: I have no financial or other arrangement with any of these, but have written for both Sermo and Medstro, and am a discussion panelist later this month on Medstro.) The list goes on and on, and keeps growing. Websites and apps abound; they all go mobile, so much content to explore. So much time to waste!

“Waste of time” is the most common and scathing criticism leveled at social media by my physician friends and colleagues who have not yet seen the light. It is true: One could get lost for hours. But you can set limits. I find that when I have gotten carried away and eventually come up for air, my getting drawn in was because I have been engrossed in the content, the opinion pieces, blogs, journal articles, and medical news. I have been connecting, networking, even discussing important topics (as with a virtual journal club).  Social media has yielded much more value and content per unit of time spent than the same time spent rifling through a journal, or surfing the Internet, cozying up to a textbook. I might also add that I am much more likely now to engage in reading this kind of content via social media than before, when faced with the stack of journals next to my desk.

There is a growing body of content — meetings, lectures, webinars, articles — extolling the benefits and raising the cautions for physicians venturing in to the social media landscape. Surgical blogger Skeptical Scalpel was published recently in a scholarly journal, summarizing the benefits of blogging and tweeting, with excellent advice as well. This recent post by The Doctors Company is also an excellent introduction and guide to social media for doctors, collaborating with KevinMD who himself provides rich content and advice on his own blog. (Disclosure: Several of my own blog posts have been re-shared via KevinMD.) Both of these posts are a great introduction. I urge everyone to avail themselves of any of the abundant seminars and lectures introducing doctors to social media, whether at medical meetings or via physician-focused websites and platforms like Sermo (the sponsor of the most recent webinar I attended). There is rich content on the Internet, and even on social media itself.

It is important to be careful of the pitfalls, but those are not sufficient to bar adoption of social media or prevent use. Be mindful of privacy and HIPAA, and aware that content once posted can never really be deleted or retracted. Be careful that private and professional content do not mix, although the reality is that there really isn’t any such thing as truly private content (except maybe for internal messaging applications, but even this content is likely “discoverable”). Cautionary tales and horror stories abound. In reality, this is not terribly different than how we comport ourselves as professionals IRL (in real life), on a smaller scale, with a smaller audience, and less exposure than the Internet and social media.

The benefits are pretty compelling, and I broadly characterize them as scholarly content, news, networking, and opinion. But one final and surprising benefit has not been written about that much, and it has been a pleasant discovery. That discovery is the sense of professional community I have found via social media. I noticed, bit by bit, as I began to blog and tweet, I have been able to find my own community of peers, my “kindred spirits” (borrowing from Anne Shirley, the heroine of Anne of Green Gables). Like the orphaned Anne, it is important to identify and find one’s own community, which in turn helps navigate the (professional) world, find meaning, support and sympathy, a place to share.

In medicine, this sense of community was fostered by the formation of our medical societies and organizations, even if it was not their primary purpose. But times have changed, and interest and involvement in these organizations has been on the decline for myriad reasons. The traditional construct of meetings and conferences, taking time away from patients and practices, is not viable for many physicians. Time is limited, and expenses add quickly, so the numbers of meetings physicians are able to attend are limited as they are compelled to be frugal with both time and money. In addition, these traditional methods of connecting — for networking, communicating/collaborating, and even educating (CME/continuing medical education is a big part of medical meetings) — are viewed as cumbersome and less relevant to doctors today, especially the younger generations.

Therefore, I also see social media as part of the solution to reestablish this sense of community and collegiality among doctors. Technology and the platforms being developed and tailored to physicians may re-create that space, where communication and collaboration can grow.

As doctors enter the world of social media in greater numbers, it is clear that rules and regulations, codes of conduct, parameters and boundaries will be established and enforced. We need be a part of this, as participants, so that we are not disenfranchised by others who would do this for us. We need to protect our voices, our communication, and ultimately our patients.

Times are changing. Change happens all the time, all around, inside and out. It is random, with no direction, both good and bad, like genetic mutations. This is our opportunity to engage and participate, to direct the change, and to make it progress.


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Marketing Your Practice Online

Marketing Your Practice Online | Online Reputation Management for Doctors | Scoop.it

In previous years the conversation around marketing your medical practice centered on "Should I market my practice?" and "How much should I spend on marketing my practice?" Which then evolved into "Should I be online?" and "Is Facebook or social media really necessary to market my practice?"

Not anymore.


The conversation is now "How much time and money should I invest in online marketing?" It is now accepted that online marketing is not just an option for practices any longer; it is something they must do to attract new patients and stay competitive.


Determining cost


When determining a budget for your online marketing, it is best to start with the end in mind. Begin by looking at what your goals are for your online marketing program. I think it's best to frame them within short-term and long-term scenarios.

Here are some examples to get your creative wheels turning:

In 90 days, I would like to see an established and engaged audience of X number of people.

In 120 days, I would like to see my audience at X number, and receive X new patients per month from online efforts.

Once you have your goals set, you can determine the cost to achieve them. There are a number of factors to consider when determining the cost:


• Where does your ideal patient hang out?


Hint: Almost all practices should start with a website and Facebook.


• Who is managing the online effort — in-house vs. an outside firm?


There are many different levels of service available; from assistance with in-house efforts to complete outside management.


• What is the cost to reach your ideal patients?


Do you want to reach the 22-year-old diabetic patient in Boise, Idaho? You can, and often times for pennies. If you want to make your message more specific, it may cost a little more or less depending on the characteristics you seek.


• How will you stay in touch?


All of these variables, and many more, factor into what kind of investment you will need to make to reach the patients you want to see.

Compare these figures to what a single patient is worth to your practice to calculate how much time and money you should invest in online marketing efforts.


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Marketing Your Practice Online

Marketing Your Practice Online | Online Reputation Management for Doctors | Scoop.it

In previous years the conversation around marketing your medical practice centered on "Should I market my practice?" and "How much should I spend on marketing my practice?" Which then evolved into "Should I be online?" and "Is Facebook or social media really necessary to market my practice?"

Not anymore.


The conversation is now "How much time and money should I invest in online marketing?" It is now accepted that online marketing is not just an option for practices any longer; it is something they must do to attract new patients and stay competitive.


Determining cost


When determining a budget for your online marketing, it is best to start with the end in mind. Begin by looking at what your goals are for your online marketing program. I think it's best to frame them within short-term and long-term scenarios.

Here are some examples to get your creative wheels turning:

In 90 days, I would like to see an established and engaged audience of X number of people.

In 120 days, I would like to see my audience at X number, and receive X new patients per month from online efforts.

Once you have your goals set, you can determine the cost to achieve them. There are a number of factors to consider when determining the cost:


• Where does your ideal patient hang out?


Hint: Almost all practices should start with a website and Facebook.


• Who is managing the online effort — in-house vs. an outside firm?


There are many different levels of service available; from assistance with in-house efforts to complete outside management.


• What is the cost to reach your ideal patients?


Do you want to reach the 22-year-old diabetic patient in Boise, Idaho? You can, and often times for pennies. If you want to make your message more specific, it may cost a little more or less depending on the characteristics you seek?


• How will you stay in touch?


All of these variables, and many more, factor into what kind of investment you will need to make to reach the patients you want to see.

Compare these figures to what a single patient is worth to your practice to calculate how much time and money you should invest in online marketing efforts.

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The Ever-Full Yet Fulfilling Days of Being a Physician

The Ever-Full Yet Fulfilling Days of Being a Physician | Online Reputation Management for Doctors | Scoop.it

Monday morning began with the “hurry up and wait” chaos so common on labor and delivery, followed by three deliveries in just under 24 hours. The last one occurred a mere 40 minutes before my first patient was scheduled Tuesday morning. Fortunately, this week I had the forethought to bring office clothes with me to the hospital so that I did not have to grace the clinic in my ever-fashionable scrubs.

While downing my Starbucks, I plowed through my morning schedule. I placed an IUD, checked a C-section scar, pondered the implications of my patient calling out an ex-boyfriend’s name during sleep sex, reviewed diabetes medications and glucose control in light of new peripheral neuropathy, had a required “face-to-face” appointment to replace medical equipment that had already been approved twice before for a permanent condition, and then ended the session with a 21-year-old already plagued with chronic back pain who has exhausted two neurologists, one neurosurgeon, and a pain management specialist. Thank goodness my first two patients had to reschedule and one cancelled or I would have been running even later than usual.

As the last patient checked out I tried to keep my eyes open to review the ever-growing number of tasks in my box alerting me to prior authorizations that I had to complete for medications my patient has been on for many months, paperwork for a child that had not been seen in over two years, and stat refills for a patient who ran out of his medications four days before. I had not yet started my billing for that morning’s session.

Tuesday afternoons usually permit some administrative time, however, residents were streaming into my office with myriad questions, my prenatal coordinator had concerns about a new OB patient’s hepatitis C test results, and one of the rotating medical students asked for a letter of recommendation.

I meant to bring home the day’s notes and billing to do at home after the kids were tucked into bed, but once dinner was done I collapsed in bed, intermittently interrupted by the baby waking up at one and three and five.

Wednesday morning I did not see patients, instead I sat in the preceptor room and reviewed ambulatory patients with residents. I was hoping again to get to the billing before the office manager started complaining. However, the residents had challenging patients and I spent the morning explaining the need to correct for prematurity when looking at developmental milestones, reviewing Pap smear screening guidelines, and identifying who actually needed blood work that day. The last resident patient was scheduled for just before lunch and as I sat waiting for the residents to finish, one of my advisees popped her head in to ask if we were still meeting during lunch. I assured her that I would be in my office in about 15 minutes and made a mental note to remind myself to write those types of meetings down because I had completely forgotten.

This resident is in her last year of training and that day we discussed outstanding items for her to complete before graduation, tallied up how many office visits she needs to complete before July, and talked about her career goals. The conversation continued until I realized that the lunch had taken us 15 minutes into my afternoon patient session. Wrapping up, I stepped out of my office to huddle with my nurses, finding a fourth-year medical student waiting to work with me. I sent her in to see the first patient while I reviewed previsit planning with my team.

The afternoon patients were intermingled with residents coming to discuss prenatal patients, as well as my office staff looking for my signature on a variety of paperwork. Additionally, the school guidance counselor called to discuss my middle daughter’s schoolwork. The medical student helped immensely that day, as she gave extra attention to my patients. We had a two-month old needing immunizations coming in with her 16-year-old mother whom I had just placed a hormonal implant last week. This visit let me check on both mom and baby. When I finished with the last patient and reviewed with the student, I still had phone calls to make and results to verify.

Thursday started with a faculty meeting running 15 minutes into my morning patient session. Fortunately, the first patient didn't mind waiting. Again I seemed to whirl through patient rooms, reviewing a urinalysis here, ordering blood work there. I had a new prenatal patient that day. It was her first pregnancy after struggling with infertility for years and I spent more time than I should, or perhaps more correctly, more time than I was allotted with her, so again I fell behind.

Friday is looming for me. There is still charting and billing to complete. It has been a long week with seemingly endless paperwork and phone calls. But over the course of the week I helped three babies into the world, taught young doctors, and took the extra time my patients needed me to take.


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Strategies to Market Your Practice for Success

Strategies to Market Your Practice for Success | Online Reputation Management for Doctors | Scoop.it

Any successful realtor knows how important it is to stage a home to attract the right buyer — the same principal applies to medical practices. There are tons of ways you can "stage" a practice to attract the right patients; some are legally required, some are practical, some are fun, and some are just plain smart-business. One of the key ways to stage your practice for success is your marketing program.


Many practices have interpreted their professional responsibility as an obligation to see and treat virtually any patient who can use the telephone and present his body in their office. But this can lead to a revolving door of acute patients, rather than long-term patients, and can leave you stressed and strap your practice marketing budget.


I am not suggesting that if you have the capacity to serve those seeking care, you deny them access. What I want you to do is to stage your practice for success by identify characteristics of those patients you especially enjoy serving, and make a specific marketing effort to attract and retain those patients.


Patients that you especially enjoy seeing are called "ideal patients." Every practice, and possibly even practitioner, will have a different set of qualifiers that create their ideal patient. There are a few qualities that universally belong on all ideal-patient profiles. All ideal patients are patients:


• You enjoy working with;


• That need your help;


• Who will happily pay what you are worth (privately, via insurance, or a combination); and


• That will get great results from the services you can or do offer.


Now taking a look at just that short list of criteria, can you imagine what it would be like to have a practice full of these types of patients? I challenge you to stage your practice for success by taking the steps to identify and market it to your ideal patient, rather than casting so large of a net that you are seeing patients you don't enjoy seeing, and who don't stick around your practice.

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Newscenter - Online reputation management for physicians

Newscenter - Online reputation management for physicians | Online Reputation Management for Doctors | Scoop.it

As more patients go online to find information about physicians, your reputation is being built and managed on the Internet. And like it or not, your online reputation plays a role in acquiring new patients and maintaining trust with existing patients and colleagues. It is imperative for physicians to have a plan and focus on online reputation management.


Online reputation management is the process of preventing and repairing threats to your online reputation. It is done by tracking what is written about you and using techniques to address or moderate the information on search engine result pages or in social media. The goal is to promote positive or neutral content while suppressing negative content.


For physicians, online reputation management involves addressing information in three areas:


  1. information found on search engine results pages (Google);
  2. information found in social media (LinkedIn, FaceBook, blogs); and
  3. information on rating sites, such as Vitals, HealthGrades, Rate MDs, Yelp, and Angie’s List.


Recently, a physician received an email from a company offering online reputation management services to help him mitigate negative online reviews on sites such as Yelp, Google, and health care review sites such as Vitals.


There are hundreds of companies out there offering these services. However, physicians are urged to use extreme caution when choosing a reputation management company. Some companies engage in questionable techniques that could lead to disciplinary action by the Texas Medical Board (TMB).


Specifically, the company that emailed this physician said they “will post reviews for our clients to over 40 social media web sites . . . We post up to 25 reviews per month.”


This claim is alarming in the context of medical practice. How are they managing to post reviews from the patients of a particular physician? Are they making up reviews and then posting them? It is unethical and dishonest to post reviews on these sites that are not from actual patients. Physicians are held to a different standard than other businesses, and posting fake patient reviews is problematic. Doing so would also violate TMB advertising rules, as this type of advertising (and the TMB does consider this to be advertising) would be considered “misleading.”


Here are a few techniques for managing your own online reputation.

 Know what is being said. Conduct web searches on yourself and your practice regularly. Review the first 30 hits of the search. (Any hit past 30 is generally considered extraneous and not likely to be read.) (1) Among the top 30 hits, what are these sites saying about you? Continue to monitor these online discussions.


 Know what you can and cannot do about negative reviews.  Because of health care privacy laws, physicians cannot respond to online reviews. The fact that a patient’s identity is protected information directly hinders the physician’s ability to refute a complaint. Simply acknowledging publicly that the complaining party is a patient breaches confidentiality and violates HIPAA.


Physicians can consider giving patients more constructive ways to offer their feedback. Conducting a patient survey, for example, would be a good way for patients to express their dissatisfaction and feel empowered.


Another option is to talk to the patient directly if you can identify who made the comment. This should be done in person or over the phone. Begin by asking the patient why he or she is dissatisfied.


It is also a good idea to investigate the patient’s complaints. Is the complaint legitimate? Was the problem with a procedure, a staff member, or the patient's wait time? Can the problem be fixed?


 Optimize your site for search engines. Optimizing your site for search engines will ensure that anyone typing in your name or your practice name will see your web site at the top of the search list. Optimizing your site involves creating comprehensive and targeted meta tags and web site page titles that help search engines index your site. More sophisticated techniques include editing your site’s content, HTML, and associated coding; removing barriers to the indexing activities of search engines; increasing inbound links; or purchasing related web addresses.


Create your own blog. You cannot control what other people say about you online, but you can create your own story and your own content. Your blog could be as simple as one 300-word post per week. The content could be about services you are offering to patients, the importance of getting a flu shot, or any other health topic that is relevant to your patient base.


 Create a LinkedIn profile. Your LinkedIn profile is another aspect of your online presence that you create. Add information about where you went to school, your specialty, and your practice. Make your profile public so that patients and potential patients can learn about you in a way you can control.


Take advantage of that “thank you.” The next time you receive a thank you note or email from a patient or family member, ask that person to post their comments on your blog, on your LinkedIn profile, or on physician rating sites.


 Keep in mind that with the prevalence of smartphones and tablet PCs, patients can post a review of you — a positive or negative review — at anytime and from anywhere. Even from your waiting room. Don’t ignore what’s being said.

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Pearls for Improving Your Online Reputation

Pearls for Improving Your Online Reputation | Online Reputation Management for Doctors | Scoop.it

The Internet has leveled the information playing field, allowing all members of society access to information about their doctors and their health care. Data reported by Credential Protection indicate that specific doctor names are searched dozens of times to over 50 times daily by patients. Often, patients book surgery with a surgeon and then research the doctor after the appointment.


For medicine, the impact of the telecommunication revolution has been profound. What patients find through Google searches and on social media and online review sites can influence the doctor-patient relationship.


Maintaining a successful online reputation requires three basic components: patient capture, patient engagement, and patient retainment. If all of these components are not strong, doctors will lose patients. If patients cannot find you on the Internet, then from their point of view you do not exist, and you fail to capture those patients. If patients do not feel engaged on social media, then you may not be interesting enough for those patients to seek your care. If patients see bad online reviews, then a tarnished online reputation will drive those patients away. In the digital age, doctors must develop a strong online reputation through these three online components.


Because of the ongoing telecommunications evolution, marketing through the Internet, social media, and doctor- review websites is becoming more cost-effective than traditional advertising modalities such as phonebooks, newspapers, magazine, radio, and television. Online review sites such as Yelp! and Angie’s List have become well-known and serve as a new type of word-of-mouth marketing in the digital age. These sites allow users to leave comments about their customer service experiences, products they have purchased, and other information for other people who may be looking for such advice.


Physicians and their practices are not exempt from these online reviews. Sites that allow patients to talk about their experiences at the doctor’s office and recommend (or not recommend) the practice can be helpful or harmful. Glowing reviews can attract new patients. However, negative or unjust reviews posted by competing doctors or disgruntled patients can affect a doctor’s business and professional reputation, potentially leading to lost patients.


Most current online review sites are unsatisfactory because anyone with a valid e-mail account can leave reviews anonymously. Online review websites that depend mainly on advertising dollars often look unprofessional and may even place competitors’ ads alongside doctors’ profiles. Dealing with slanderous or false reviews can be frustrating and time-consuming.


Unfortunately, I have been a victim of slanderous online reviews. After graduating high school, I devoted 17 years of my life studying to become a physician and surgeon, attaining medical and doctoral degrees at the Johns Hopkins University School of Medicine. I have a distinguished curriculum vitae and have dedicated much of my adult life to serving patients in a professional and ethical manner. One day after the grand opening of my private practice, I was attacked online by an anonymous poster who called me a “money grubber” on a third-party online review site. Most likely I was the victim of a competing doctor or disgruntled associate, although I may never know. This insult was applied to me even though I have spent considerable time seeing patients at the Temecula-Murrieta Rescue Mission at no charge, not billing the patients, and giving glasses away at no cost for those who cannot afford them.


You see, therefore, why I say most current online review sites are unregulated and severely unjust, and they can have horrible consequences for doctors. Online review websites are natural magnets for negative reviews. An outstanding doctor who never has angered one patient may receive no positive reviews, but angry patients can be quick to slander their doctors.


The current state of online reviews may make doctors feel helpless, angry, and frustrated. However, there are seven high-impact things you can do to be proactive and fight against defamation of your name, your reputation, and your credentials.


No. 1: Perform reconnaissance. The first step in fighting the war against slanderous reviews is to be educated on what people find when searching your name. Search your name on Google and see what others will see when searching your name. Monitor the websites that appear on the first page of Google. Use Google Alerts to receive automated emails from Google when there is new information about your name on the Internet. Monitor your online presence often.


No. 2: Erect a brick wall. In search engine management, the term brick wall is applied to a technique used to control the presentation of websites people find when searching your name. When patients search “Andrew Doan” on Google, of the more than 17 million search results, I control and monitor the 9 or 10 websites that appear on the first page of the search. Controlling what people find in this way can draw attention away from less-credible doctor-review sites.


No. 3: Use search engine optimization and management. The use of search engine optimization and management can help raise the websites you want to appear higher in search results. One effective way to accomplish this is to add your practice website address to all social media profiles, such as Facebook, Twitter, LinkedIn, and Google+.


In addition, using social media websites such as Facebook can be an effective way to guide patients to your practice and to engage them in a controlled environment. Patients who “like” or comment on your page are helping you broadcast your practice to their personal connections. This is one form of word-of-mouth marketing in the digital age.


No. 4: Be a good, ethical medical professional. This sounds like common sense, but medical professionals may come to feel entitled and forget that being a good doctor means serving other people. Try to serve others with a caring heart, but without expecting anything in return. Remember that it is a privilege to work in the medical

profession and to be employed during these difficult economic times. Learn to love what you do. Unhappy medical professionals will foster unhappy patients, leading to bad online reviews.


No. 5: Encourage patients to post feedback online. Receiving positive reviews is as easy as asking patients to review your services online. The problem is that there are dozens of review websites, and only a fraction of patients will take the time spontaneously to post reviews online. If you don’t ask, most likely patients will not post reviews for you.


No. 6: The solution to pollution is dilution. Negative reviews are not necessarily bad. We all want to be perfect, but in reality nobody is perfect. A study by researchers at the Stanford Graduate School of Business found that in some cases negative publicity can increase sales when a product or company is relatively unknown, simply because it stimulates product awareness.1 Embrace the negative reviews, learn from them, and become a better doctor tomorrow than you were today.


Unfortunately, not all review websites represent true patient reviews; they may be postings by local competitors or slanderous individuals. The solution to negative reviews is not litigation or gag orders, which may expose one to ligation for violating free speech laws, as was seen in a case involving a New York dentist.2 Also, posting of false testimonials to one’s own practice can lead to loss of medical license and a large monetary fine, as occurred in the case of a New York plastic surgeon in 2009.3


The answer to negative reviews is to learn from the review and then accumulate more positive than negative reviews.


No. 7: Encourage the posting of third-party verified reviews. Work with a third-party organization, such as Verified Reviews, that will collect, process, and post reviews on your behalf. One answer to the current review system that naturally attracts negative reviews is to have a credible organization collect, verify, and post reviews to protect both doctor and patients.


First-mover advantage—a marketing term meaning the advantage gained by being the first to take advantage of a particular market segment—is important when encouraging patients to review your medical and professional services. First-mover advantage allows a doctor to accumulate more reviews than the competition.


When patients search for doctors on the Internet, the two most influential factors are the star rating and the number of reviews for a doctor; the higher the star rating and the greater the number of reviews, the greater the competence and value conveyed to patients.

CONCLUSION

The advancement and evolution of information technology is exciting, but it also presents new challenges for physicians and patients. Many patients prefer Internet resources and are likely to use online resources as their primary reference, including searching for, finding, and reviewing doctors. Your online reputation rests in their hands. The advice in this article may help return some of that control to your own.

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Physician Online Reputation Management Strategies

Physician Online Reputation Management Strategies | Online Reputation Management for Doctors | Scoop.it

In today’s world, where information can be shared and exchanged freely and with virtually no filter, people are looking increasingly towards the internet for advice on a number of things, from what to wear, to which sports teams they should bet on and even to what doctors they should and shouldn’t be going to.


And while the fact that information like prices, plans, insurance policies and such are available online is certainly a good thing, as people can easily find adequate and convenient treatment for almost any condition, it also means doctors are subject to a lot of evaluations, which are often subjective and not necessarily backed by fact.

Most online reviews, whatever their subject is, tend to be quite short and to the point, and usually not very elaborate. In fact, most of the times, online reviewers on websites like Amazon and eBay stick to just ratings, not even adding a comment. The same kind of trend has been observed for those websites which rate doctors, with most comments proving to be either excessively positive or negative – either way, not particularly helpful.


In a scenario like this, any doctor may get a very bad rating, or a very vague unfavorable review just for taking too long to assist a patient, looking at someone’s girlfriend or any other reason, but since the comment is vague, or there is no comment at all, these ratings may cause huge damage on a medical professional’s career when such damage was unwarranted.


This means doctors need to be extra careful with their reputations these days. They need to not only tick all the right boxes’ both professionally and socially speaking, but they must also go beyond that and be a part of a whole which is as close as possible to perfect – offering the best rates, most competitive plans and accommodation conditions for in-patients.


Furthermore, they need to have a positive social media presence, and possibly even a completely squeaky clean’ life, so that patients can’t find anything which could be perceived negatively about them, and feel safe when leaving their lives in these physicians’ hands.


It may seem unfair to be held to such an unbelievably high standard, but this is the result of the modern social media culture, which was partially molded by celebrity. The only way to stay afloat is to play the game, taking stock of what is actually being said, taking advantage of the good and learning meaningful lessons from negative comments, if at all possible.


However, it all starts in the examination room, so even before you consider your online profile, it is a good idea for doctors to look at the way they behave in their professional setting, and how patients react. While negative comments can stem from just about anything, a number of them is fueled by the sense of being mistreated or disrespected, so taking a few more minutes to listen to patients properly and try to empathize can make all the difference.


And even if these professionals think their capabilities and career speak for themselves, they shouldn’t let them. Instead, they should be proactive, making sure all the information available about them is correct, and creating their own content, even replying to comments made about them in a positive and reassuring manner, so as to counteract any possible damage.


Above all, every doctor should remember that reputations aren’t set in stone. They take years to build and minutes to destroy.

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Managing online reputation for dentists

Managing online reputation for dentists | Online Reputation Management for Doctors | Scoop.it

The Internet has become the ultimate symbol of an individual’s right to information and freedom of expression. As a result, there is plenty of good information available on the Internet regarding doctors and dentists. However, along with the good information, there is also the risk of misinformation and negative biases finding its way to the World Wide Web.


The very nature of the Internet ensures so much freedom for every individual that it becomes difficult for dentists to control and manage their professional reputations online. The number of rankings or ratings websites have also increased, and some are focused exclusively on physicians. While these websites present an opportunity for dentists to promote their practices through word of mouth publicity, they also pose the risk of creating unfairly negative pinions against them.


Types of ratings websites


Doctor and dentist rating websites can be broadly classified into four categories. The first is the no-fee sites that offer free information to patients about the listed doctors. Some of these sites earn their revenue through advertising, while others charge a fee to the listed doctors. From a dentist’s perspective, it is relatively easy to control information on such a website because there is a financial tie-up between the site and the practitioner.


The second category of websites are the ones that have no relationship with the doctors, but charge patients a fee for privileged access to information about doctors. Dentists can exercise little or no control over the views and reviews that the website chooses to publish about a practice.


The third category includes insurance company websites, which have doctor reference sections, and the companies give their own ratings to the listed doctors.


The final category includes government-controlled websites that provide information about doctors licensed in the states.


How are ratings determined?


Doctor and dentist rating websites usually follow one of three approaches to develop rankings or ratings. The first involves the use of an algorithm or formula that attaches different weights to different sets of credentials of the doctor, such as education, experience, and any special training. Some sites may differentiate on the basis of the type of dental school a dentist attended. If the doctor has settled a malpractice suit out of court, some sites may consider this as grounds to attach lesser weight to the doctor.


The second approach to determine ratings involves feedback from patients. The website will invite patients to rate their doctors on various parameters. Average ratings for a doctor are then computed on the basis of the patient feedback.


The third approach is a hybrid of the first two, which is a more comprehensive way to develop ratings. However, rating a dentist still remains a highly subjective area because the opinions vary widely from patient to patient. That makes this entire system of online ratings inherently controversial.

Proactive online reputation management


From a practicing dentist’s point of view, it makes a lot of sense to be proactive in protecting and managing his or her online reputation. A growing number of patients are inclined to check out a doctor’s background on the Internet, and it may become an important factor in their decision to choose a doctor. The first challenge for a doctor is to ensure that the ratings and review websites maintain the latest information about the doctor’s practice. Most such sites do not have a system to ask for such updates, and the sites expect the listed doctors to provide updates on their own.


Patients may get mixed up when two or more doctors have the same or similar names. It may lead to misplaced patient reviews and ratings. Sometimes a particular patient may have made an unfair, false, or incorrect accusation, which can be countered only if the doctor takes care to tell his side of the story. Apart from damage control in such instances, dentists should also reach out to ratings and review sites to provide accurate facts so that the chances of misinformation are minimized.


Challenges of anonymous ratings


The Internet offers a great deal of anonymity, which can be misused to make irresponsible, incorrect, or false statements online, without any fear of being held accountable. Many individuals operate under pseudonyms on the Internet. So while they can hide their identity and protect their reputation, they can potentially jeopardize the reputation of a dentist or other professional online. To tackle this challenge, Google Plus has taken the initiative and revoked the ability of users to post reviews anonymously, or even pseudonymously.


While this kind of restriction is a welcome step for most businesses and professions, it poses another unique problem in the area of health care. Patients are usually willing to be most candid when their privacy is protected. Less than 5% of patients willingly give out their full names when providing feedback about a doctor online. Therefore, restriction of their privacy is a dilemma that may discourage patients from providing reviews and ratings about doctors and dentists on respected forums such as Google Plus.

Hire online reputation management experts


Dental practitioners who are looking to grow and expand their practices in their area can no longer afford to ignore the marketing power of the Internet. They should have a professional and dynamic website that creates an outstanding image for the dentist and practice. Secondly, such a website needs to be promoted professionally so that it achieves high rankings on all search engines, which allows the maximum number of local patients to reach the website. Thirdly, the dentist must be able to protect his or her reputation on third party websites on the Internet.


All these tasks can be performed efficiently and cost-effectively with the help of a professional SEO and online reputation management services provider. With the support of recognized experts in this area, it is possible to build an impeccable online reputation for a dentist, while following the highest ethical and professional standards.

It takes years to build an online reputation, and it can take one bad review that goes viral on the Internet to tear it down. With the growing influence of the World Wide Web in our lives, it is a smart move for practicing dentists to take the steps to build and protect their professional reputation online.

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Are You Avoiding Social Media? Maybe You Shouldn't.

Are You Avoiding Social Media? Maybe You Shouldn't. | Online Reputation Management for Doctors | Scoop.it

I'm not a big social media user. I don't tweet or Instagram or Snapchat — I'm only on Facebook so I can see what my kids are posting. I figure my coworkers hear enough from me while we're inside the office that they don't need to know every single thing I'm doing outside of it.

I meet a lot of physicians who feel the same way, who do everything they can to keep their professional and personal lives separate. But I recently read a study that made me think a bit differently.


According to CareerBuilder, 35 percent of employers are less likely to interview candidates they can't find online. And that's not just IT folks or sales employers. Nearly 50 percent of healthcare employers look at social media to screen candidates.


So what does this mean to physicians who are considering a new job? It's time to get online.


Start by googling yourself


Unfortunately, no matter how hard you try to keep your life off the Internet, chances are good you're still there. Take a second and type your name into Google. You might see a link to your current employer, an old photo from an alumni publication, or the minutes associated with political causes you've donated to. And you will certainly see patient reviews — both good and bad — on websites like HealthGrades.com.


Now put yourself in an employer's shoes. What do these Google results say about you? Do they paint a complete picture of you as a physician? Do they highlight your skills? Your professional accomplishments? Your rapport with patients?


If not, you've got some work to do.


Find the right type of social network


Not all social media networks are created equal. Facebook is great for sharing pictures and stories with those you're close with. Twitter is good if you want to interact with strangers or weigh in on issues in real time. But if you're looking to create a professional profile, I recommend you start with LinkedIn.


LinkedIn is a great place to tell your story. Not only can it house your resume, but it also allows you the freedom to bring your CV to life. You can highlight professional accomplishments, share why you're passionate about medicine, or promote your research. It also allows you to reconnect with former colleagues or friends from medical school who could help you get the inside track on a new position.


Once your profile is complete, potential employers can easily find you online and get a quick snapshot of both your professional experience and who you are as a person. And most importantly — as opposed to online review sites — you control the message.


LinkedIn is not the only option. ZocDoc and Vitals also allow physicians to create a custom profile with photos, credentials, and accomplishments. Because these sites are targeted at consumers, they also include patient ratings.


Be careful of what you share


If you're looking for a new job, or just want to have an impact on what people see when they Google your name, having a social media presence may be a good idea. But once you're online, make sure to think before you post. HIPAA regulations apply on social media, too, so never reveal names of patients you're treating or post photos of things that could identify them; e.g., charts, notes, or X-rays.


It's also smart to keep things positive. A lot of people use social media to vent about their job, boss, or coworkers. Even if these messages never get back to the involved parties, they can be a real turnoff to potential employers.


When in doubt, keep it simple. Maintaining a succinct professional profile on one or two social networks will allow employers to easily find you online and help you present your best self to your next boss.

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What Physicians Should Consider When Managing Their Online Reputation

What Physicians Should Consider When Managing Their Online Reputation | Online Reputation Management for Doctors | Scoop.it

Your online reputation as a physician is valuable; probably even more so than you may realize. But if you do not manage your reputation the right way, it could lead to huge difficulties. The Internet has opened up the door to allowing people to find your practice easily, but by the same token it has made it possible for there to be fraudulent information and negative reviews, all of which can do damage.

It Looks Real

There are several problems with online reviews that will be imperative to act upon for physicians. For starters, it is illegal for you to pay someone to write a favorable review for you. This is a process known as "astroturfing," and is a problem that has plagued the Internet for years. With astroturfing, people (or sometimes the physician themselves) will log on to review websites and will leave glowing reviews, simply because they have received something in exchange (e.g. cash and/or incentives) for those reviews other than good service.


The reviews give great feedback and are typically "over the top," in regard to the product or service. In contrast, there are some people who will get others to purposely write negative reviews of their competitors, when there is a chance they have never been a customer at all.


The Legalities


What many people fail to realize is that astroturfing, fake reviews or reviews done in exchange for something, is illegal. In most cases it may qualify as a violation of the Endorsement and Advertising Guidelines, which are standards set by the Federal Trade Commission. Fake reviews have lead to monetary sanctions being placed against those who have written them.


Physicians need to exercise caution when it comes to managing their online reputation. It is essential to balance review management while remaining legal. While you can suggest to your happy customers to leave a review for your practice, it is best to avoid offering them something, such as a discount, gift, or money, for doing so.


Managing Carefully


It is estimated that good reviews can boost a business’s sales anywhere from 32 percent to 52 percent, according to the Harvard Business Review. So it stands to reason that a business with poor reviews will in turn lose current customers, or prevent new ones. For example, one Washington, D.C., building contractor fought back when he received a negative online review that he believes lead to him losing $300,000 worth of business. The contractor, who sued the person who wrote the review, claimed that it contained information that was not factually correct and it cost him a lot of business.


It is imperative that physicians manage their online reputation. But navigating the waters to get it done successfully, as well as legally, may prove to be challenging for some. This is a reason some people turn to reputation management companies. They know how to manage the online reputation, keep it all legal, and help you gain business as a result.

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Six Ways to Improve Patient Satisfaction Scores

Six Ways to Improve Patient Satisfaction Scores | Online Reputation Management for Doctors | Scoop.it

Large physician practices and hospitals already have a portion of their payments linked to patient satisfaction. Over the next few years, it will be an integral portion of physician payment, including penalties possibly dwarfing those under meaningful use. More about this program, known as the Clinician & Group Consumer Assessment of Health Providers and Systems (CG-CAHPS) can be found on the Agency for Healthcare Research and Quality's website.

Here's the government's hypothesis in a nutshell:


• Patients who like their doctors are more likely to be compliant patients;

• Compliant patients are healthier patients;

• Healthier patients are less expensive; so

• Physicians with satisfied patients should be paid more than physicians with dissatisfied patients.

The Affordable Care Act introduced a different set of quality metrics than used by the Institute of Medicine (IOM): quality, patient satisfaction, and payment. Quality is a key element with both programs, but there's an important difference with the reform law: your patients are the arbiters of quality. Quality more or less equals patient satisfaction.


What's being measured?


CG-CAHPS measures the patient experience, an expansive proxy for quality that takes into account the following:

• Timely appointments

• Timely care (refills, callbacks, etc.)

• Your communication skills

• What your patient thinks about you

• What your patient thinks about your staff

• Your office running on schedule

I have been in enough medical practices — both as a patient and as an administrator — to know there's a method to this madness. It's less about the care and more about the caring. Here's what I suggest for improving your quality measures via these proxies.


1. Hire sunshine.


I can train anyone* to do anything in our office, but I can't train sunshine.  Look to hire positive and happy people, particularly for roles with lots of patient interaction. Your patient satisfaction — and thus, your "quality" — will improve. You'll also find a cost-saving benefit to this hiring tactic: employee turnover will shrink.


2. Start on time.


CG-CAHPS asks patients whether they were seen within 15 minutes of their appointment times; it's even underlined for emphasis. Physicians who start on time are more likely to run on time, so have your feet set before you start running.


3. Set patient expectations.


It's helpful to share with patients the FAQs about your practice so that they know what to do for refills, after-hour needs, appointment scheduling, etc. By making these answers available on your website, on your patient portal, and in your print materials, you'll better align patient expectations with patient experiences and thereby score better on quality surveys.


Some patients gauge quality by whether or not they get the antibiotic they think they need. It's helpful for primary-care physicians to include education on antibiotic overuse in their patient education materials.

Along these lines, it is important for your patient to know what to expect after their visit in terms of test results, follow-up visits, etc. I receive more complaints about the back end of our patients' experiences than anything else. Make sure you and your staff do not drop the ball as you near the goal line.


4. Listen with your eyes.


Nothing says "I don't care" like having your physician focus on a computer screen rather than on the patient. This is particularly true in the first couple of minutes of each visit, and especially important with new patients. One virtue of using medical scribes is that you can listen with your eyes a whole lot more.


5. Put your staff in their place.


Your staff has an important bearing on the patient experience. I'm a big fan of letting them know their actions influence quality. It's pretty cool, for me as a mere bureaucrat, to know that I can improve quality simply by being friendly and helpful to our patients. Make sure your staff knows that making a patient's day is a beautiful act.


6. Monkey see, monkey do.


Staff will follow your lead. If your thoughts and actions emphasize running on schedule, being kind to patients and their families, and not dropping balls, they'll be stronger teammates for you.


Patient satisfaction has always been a gauge of quality, just as patient referrals remain the lifeblood of most practices. Treat this next wave as an opportunity to show off the caring that has always been a big part of the medical care you offer your patients.

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Online Patient Engagement Requires Practice Buy-In

Online Patient Engagement Requires Practice Buy-In | Online Reputation Management for Doctors | Scoop.it

Patients are taking a greater role in their healthcare than ever before, and a growing array of electronic tools are available to help physicians engage them, according to Shannon Vogel, director of health information technology at the Texas Medical Association during the Healthcare Information and Management Systems Society (HIMSS) 2015 annual conference.

Nearly 90 percent of U.S. adults use the Internet and nearly three-quarters of them have used the Internet to search for health information, according to 2012 data collected by Pew Research Center. Additionally, 58 percent of U.S. adults own a smartphone and more than half of smartphone owners have used their device to access health information. Vogel summarized the growing tool chest of electronic patient engagement options for practices, including patient portals, personal health records, Health Information Exchanges (HIEs), direct protocol e-mails, and health applications, and their respective advantages.

Vogel explained that the use of all health information technology in practice is still in its infancy, but patient demand and CMS meaningful use incentives are driving rapid growth in the use of these technologies. A survey by the Texas Medical Association found that between 2005 and 2014, the use of EHRs in Texas grew from 25 percent to 69 percent of practices.

Patients often want e-mail reminders, online scheduling, the ability to e-mail their physician, and online access to test results and their records. The most common way practices are working to meet these demands is by creating patient portals, Vogel said.

Patient portals are often part of the practice's electronic medical record, Vogel explained. All portals offer secure messaging between the practice and patient and a summary of the patient's clinical information. They may also include appointment scheduling, bill paying, or customized options.

Portals can help to reduce a practice's administrative costs and streamline workflows. They can also help practices meet meaningful use requirements, such as patient access to their medical records, patient reminders, and secure messaging, Vogel said.

"It's a great way to bring value back to the practice," said Vogel.Shannon VogelShannon Vogel

But one downside of portals is that patients with multiple physicians may wind up with multiple portals. One option that has emerged to help patients keep all their health information in one place is the patient health record (PHR). Patients can upload medical records from their physicians into their PHR and they can also enter information about supplements, data from health apps, and other information into the record. Patients can share access to this record with their physician. But Vogel said use of PHRs so far has been low. She explained that they may not help physicians meet meaningful use requirements, though CMS is looking into ways to help with this drawback.

Some practices are offering secure e-mail messaging only, Vogel said. And in some states, HIEs are beginning to offer some electronic engagement functionality. Additionally, practices may make use of the growing array of health apps that patients can use to track their health data. She noted that physicians might use these tools to ask patients to call or schedule an appointment if the patient's readings are outside of certain parameters.

No matter what electronic tools practices chose, Vogel emphasized that it is important for the physician and practice staff to become very familiar with the tool and familiarize themselves with the patient interface. She also noted that while some patients are eager to reach out online, others may not be comfortable with this or may lack access.

"Many patients are interested, but not all have the desire, time, and access to the tools," she said. "We need to meet them where they are."


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Strategies for Dealing with Value-Based Modifiers

Strategies for Dealing with Value-Based Modifiers | Online Reputation Management for Doctors | Scoop.it

As we know many payers are implementing various approaches to pay-for-performance reimbursement or value-based reimbursement programs. Medicare has announced significant goals in modifying payment models; rolling out value-based payment modifiers (VBPM) this year. Patient care activity in 2015 will impact every Medicare payment in 2017. Physician groups of 100 or more will have payments affected this year, groups of 10 or more in 2016, and all groups in 2017. Medicare will determine the amount of payment incentive or adjustment based on the information noted below. The range is from - 4 percent to + 4 percent of Medicare payments.

Below are some thoughts on how you can respond to VBPMs and optimize the care provided patients and maintain or gain financial viability.


1. Continue to participate in PQRS which is the basis for the Medicare Value-Based Payment Modifier program. Understand how your profile fits within the six domains (check meaningful use): clinical process/effectiveness; patient and family engagement; population/public health; patient safety; care coordination; and efficient use of healthcare resources.


2. Access your practice Quality and Resource Use Report, QRUR, by obtaining an IACS number from CMS. This report was published by CMS last fall and compares your practice to peers on both quality and cost measures. This can be downloaded in both PDF and excel formats. It's complex but worth spending time on to both understand and identify your practice profile.


3. Monitor your entire provider panel in key measures:

Quality:

a. Preventable hospital admissions:

• Patients with acute episodes of dehydration, UTI, and bacterial pneumonia

• Chronic patients with heart failure, COPD, and diabetes

b. All cause hospital readmissions

Cost — your practice status:

a. All Part A and Part B payments (Part D excluded)

b. For disease categories: COPD, heart failure, coronary artery disease, and diabetes

c. Medicare Spend Per Beneficiary, MSPB, for three days prior to and 30 days post discharge

d. Total Medicare Allowable per applicable CPT code

4. Report monthly on what is occurring.

a. Your practice will not know the Medicare ranking until the end of period.

b. Rankings are determined by the eligible provider (EP) who has a "plurality" of primary-care codes assigned and the Medicare allowable charge amount assigned. Primary-care providers will be considered first, but any specialist may qualify.

c. A minimum of 20 episodes per measure (see quality above) hence the need to monitor your practice. If insufficient numbers are there, you may not see either the incentive or adjustment.


5. Regular review and reporting will help lead the practice toward a more "quality" impact and focus. When all staff, not just providers, work together, the cumbersome nature of reporting will become easier and part of everyday practice life — since in many cases the impact is not significant this year. It will however become more impactful in the years to come, as not only VBPM programs come into play, but overall payment model reforms are implemented. There will be an eventual culture change!


Long term outcomes for practices should be improved patient care, compliance with the new paradigm, and an improved financial picture. How you approach it now may determine the long-term success and viability of your practice in the future.


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Sharing Job Performance Standards With Medical Staff

Sharing Job Performance Standards With Medical Staff | Online Reputation Management for Doctors | Scoop.it

An interesting event occurred this week in my practice that I'd like to share with you. Although on the surface this seems like one of those "Well, of course" moments, oftentimes managers overlook the obvious and then wonder what went wrong.

A staff member requested and was given permission to split his time between two medical offices, hoping to build up his portion of the business in two locations rather than just one. A few weeks ago, I noticed some lax behavior on his part, resulting in not meeting expected job performance in the areas of billing charges out, completing chart notes, and communicating scheduling times. I watched and monitored his behavior to gather enough consistent information to approach him and address the problem. What resulted was a fantastic meeting of the minds; a positive and non-threatening interaction that resulted in much improved performance.

When we sat down to speak, the staff member appeared very anxious. I was unsure why this behavior was being exhibited, but knew there was a reason. So, as we started talking, I explained to him that the second office he was now working in had higher expectations from their staff members than perhaps some of the other practice locations. Many of our staff members want to work in this location due to the clinic directors' leadership style. So, as a result, the expectation of staff performance, communication, and professional attitude is higher.

The staff member asked me to expand on that. I mentioned that he failed to chart and bill out charges within 24 hours of the patient visit. I asked him why he felt this was appropriate behavior. He told me no one had ever spoken with him about what was required or expected in this area. I then asked about communication regarding scheduling. A similar answer was produced. It occurred to me that when the staff member was hired, he was pointed in the direction of his workstation, and told, "Okay, go to work." That was it.

Now, I understand that everyone gets busy and when a new employee starts, sometimes it seems like no one has the time for a proper introduction, training, or communicating basic requirements of the job. This is clearly the case with this employee. After a mere 30 minutes of explaining what the requirements for working in this office meant, we had some brainstorming and idea discussion. The employee had not been exposed to having the autonomy to "own the position," and be part of the solution, rather than part of the problem.

The result? All missing chart notes were completed within 24 hours of our meeting, and have been kept up with the expectation that was provided. The staff member has been asking for assistance with marketing the office and working in the new location. He is communicating with the front desk about their scheduling needs and requests. The staff member is keenly aware that there is transparency in that office and that he is required to meet and exceed the standard provided if he wants to remain in that location.

It's a win-win all around. The staff member feels good about working for the practice; and the clinic director is very pleased with his addition to the team, and his performance, attitude, and overall teamwork.  So remember that instead of throwing the baby out with the bathwater, take a step back and figure out why a staff member behaves the way he does, and just have a frank conversation with him.


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Marketing Your Practice Online

Marketing Your Practice Online | Online Reputation Management for Doctors | Scoop.it

In previous years the conversation around marketing your medical practice centered on "Should I market my practice?" and "How much should I spend on marketing my practice?" Which then evolved into "Should I be online?" and "Is Facebook or social media really necessary to market my practice?"

Not anymore.


The conversation is now "How much time and money should I invest in online marketing?" It is now accepted that online marketing is not just an option for practices any longer; it is something they must do to attract new patients and stay competitive.


Determining cost


When determining a budget for your online marketing, it is best to start with the end in mind. Begin by looking at what your goals are for your online marketing program. I think it's best to frame them within short-term and long-term scenarios.

Here are some examples to get your creative wheels turning:

In 90 days, I would like to see an established and engaged audience of X number of people.

In 120 days, I would like to see my audience at X number, and receive X new patients per month from online efforts.

Once you have your goals set, you can determine the cost to achieve them. There are a number of factors to consider when determining the cost:


• Where does your ideal patient hang out?


Hint: Almost all practices should start with a website and Facebook.

• Who is managing the online effort — in-house vs. an outside firm?

There are many different levels of service available; from assistance with in-house efforts to complete outside management.


• What is the cost to reach your ideal patients?


Do you want to reach the 22-year-old diabetic patient in Boise, Idaho? You can, and often times for pennies. If you want to make your message more specific, it may cost a little more or less depending on the characteristics you seek.


• How will you stay in touch?


All of these variables, and many more, factor into what kind of investment you will need to make to reach the patients you want to see.

Compare these figures to what a single patient is worth to your practice to calculate how much time and money you should invest in online marketing efforts.


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